Pizarro F, Yip R, Dallman P R, Olivares M, Hertrampf E, Walter T
Instituto de Nutricion y Technologia de los Alimentos, Universidad de Chile, Santiago.
J Pediatr. 1991 May;118(5):687-92. doi: 10.1016/s0022-3476(05)80027-7.
The objective of this study was to evaluate the benefit of screening for anemia in infants in relation to their previous diet. The iron status of 854 nine-month-old infants on three different feeding regimens and on a regimen including iron dextran injection was determined by analysis of hemoglobin, serum ferritin, and erythrocyte protoporphyrin levels and of serum transferrin saturation. Infants were categorized as having iron deficiency if two or three of the three biochemical test results were abnormal and as having iron deficiency anemia if, in addition, the hemoglobin level was less than 110 gm/L. The prevalence of iron deficiency was highest in infants fed cow milk formula without added iron (37.5%), intermediate in the group fed human milk (26.5%), much lower in those fed cow milk formula with added iron (8.0%), and virtually absent in those injected with iron dextran (1.3%). The corresponding values for iron deficiency anemia were 20.2%, 14.7%, 0.6%, and 0%, respectively. The use of iron supplements is therefore justified in infants fed cow milk formula without added iron, even when there is no biochemical evidence of iron deficiency. The low prevalence of iron deficiency in the group fed iron-fortified formula appears to make it unnecessary to screen routinely for anemia in such infants. These results also support the recommendation that infants who are exclusively fed human milk for 9 months need an additional source of iron after about 6 months of age.
本研究的目的是评估针对婴儿以往饮食情况进行贫血筛查的益处。通过分析血红蛋白、血清铁蛋白、红细胞原卟啉水平以及血清转铁蛋白饱和度，确定了854名九个月大婴儿在三种不同喂养方案以及一种包括右旋糖酐铁注射的方案下的铁状态。如果三项生化检测结果中有两项或三项异常，则将婴儿归类为缺铁；如果血红蛋白水平低于110克/升，则归类为缺铁性贫血。缺铁患病率在未添加铁的牛奶配方奶喂养的婴儿中最高（37.5%），在母乳喂养组中处于中等水平（26.5%），在添加铁的牛奶配方奶喂养的婴儿中则低得多（8.0%），而在注射右旋糖酐铁的婴儿中几乎不存在（1.3%）。缺铁性贫血的相应值分别为20.2%、14.7%、0.6%和0%。因此，对于未添加铁的牛奶配方奶喂养的婴儿，即使没有缺铁的生化证据，使用铁补充剂也是合理的。在铁强化配方奶喂养组中缺铁患病率较低，这似乎表明无需对这类婴儿进行常规贫血筛查。这些结果还支持以下建议：纯母乳喂养9个月的婴儿在大约6个月龄后需要额外的铁来源。
