Iron deficiency anemia: like mother, like child

Abstract

Iron deficiency remains a leading cause of anemia worldwide. The prevalence among infants and toddlers in the US remains close to 10% despite widespread adoption of iron-fortified formulas and the recommendation to delay the introduction of cow’s milk until 1 year of age; in developing countries the frequency is often much higher. In addition to anemia, there is evidence that iron deficiency causes long-term neurocognitive deficits that can persist despite iron replacement therapy. Although the most recent US Preventive Services Task Force guidelines recommend iron supplements for high-risk infants (low birth weight or premature), there is a surprising paucity of high-quality data regarding the value of routine screening or iron supplementation for low-risk infants. In this volume of The Journal, Zhang et al report on a retrospective review of mother-infant pairs in northern China who had enrolled in a large prospective study of iron and vitamin supplementation during pregnancy. Although they did not directly measure iron status in their subjects, this population has very low frequencies of hemoglobinopathies and infections that might cause anemia; thus, it is logical to conclude that nutritional factors (eg, iron deficiency) were a major cause for anemia when it was observed. The investigators found that infants born to women with mild anemia at the end of the second trimester (hemoglobin levels 100-109 g/L, approximately 6% of the total population) had almost double the risk of overt anemia at 5-7 and 11-13 months of age, compared with infants born to women with hemoglobin levels ≥ 110 g/L. These results suggest that maternal anemia during late pregnancy could reasonably be used as an additional risk factor to identify infants who are at increased risk of nutritional anemia and who might benefit from targeted efforts at detection and prevention, especially among resource-limited populations for whom the relative ease and low cost of hemoglobin/hematocrit measurements would be an important consideration. Article page 106▶ Maternal Hemoglobin Concentration during Gestation and Risk of Anemia in Infancy: Secondary Analysis of a Randomized Controlled TrialThe Journal of PediatricsVol. 175PreviewThis study examined the relationship between maternal hemoglobin (Hb) concentration and the risk of anemia in infancy. Full-Text PDF