Çullas-İlarslan Nisa Eda, Günay Fatih, İleri Dilber Talia, Elhan Atilla Halil, Ertem Mehmet, Arsan Saadet
Department of Pediatrics, Ankara University Faculty of Medicine, Ankara.
Divisions of Pediatric Hematology and Oncology, Ankara University Faculty of Medicine, Ankara.
Turk J Pediatr. 2018;60(1):22-31. doi: 10.24953/turkjped.2018.01.004.
Çullas-İlarslan NE, Günay F, İleri DT, Elhan AH, Ertem M, Arsan S. Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented. Turk J Pediatr 2018; 60: 22-31. Iron deficiency anemia (IDA) represents the most common cause of anemia worldwide. Because of potential irreversible neurodevelopmental impairment, its prevention during infancy is essential. We aimed to investigate the frequency of iron insufficiency among infants in a population which routine iron supplementation is implemented; and to examine related risks. A total of 501 infants, aged 9-15 months, were screened with complete blood count and serum ferritin. Infants were divided into two groups. [Group 1 (iron insufficient), [Group 1a: Iron deficiency (ID), Group 1b: IDA (IDA)], Group 2 (Iron sufficient (IS)]. Anemia was recognized in 122 (24.3%) infants. Microcytosis was observed in 110 (90.2%) of anemic infants. Group 2 accounted for 49.5% (n=248) whereas 152 (30.3%) and 101 (20.2%) infants belonged to Groups 1a and 1b, respectively. Multiple logistic regression analysis showed that male gender (OR=1.53; 95%CI 1.07 and 2.17), receiving > 500 ml/day cows milk (OR=2.77; 95%CI 0.87 and 8.83) and incompliance to iron supplementation (OR=2.51; 95%CI 1.75 and 3.60) were distinctive characteristics of Group 1 while prevalence of iron insufficiency was higher in infants consuming less formula (OR=3.10; 95%CI 2.00 and 4.80). The most frequent reasons for incompliance were consideration of supplementation as unnecessary (n=69, 31.1%) and neglection (n= 59, 26.6%). Our study demonstrated a high frequency of iron insufficiency among infants in a setting utilizing national iron supplementation and incompliance` to iron as the most evident risk factor for iron insufficiency. Effective counseling of families by health care providers concerning importance of compliance to iron prophylaxis is essential for prevention of iron insufficiency. We also suggest screening of infants for ID as well as IDA in settings with high frequency of iron insufficiency.
库拉斯 - 伊拉斯兰·内，居纳伊·F，伊莱里·D·T，埃尔汗·A·H，埃尔滕·M，阿尔桑·S。对实施常规铁补充剂的人群中婴儿铁缺乏症发生率的调查。《土耳其儿科学杂志》2018年；60：22 - 31。缺铁性贫血（IDA）是全球范围内贫血最常见的原因。由于其可能导致不可逆的神经发育损害，在婴儿期预防至关重要。我们旨在调查实施常规铁补充剂的人群中婴儿铁缺乏症的发生率，并检查相关风险。总共对501名9至15个月大的婴儿进行了全血细胞计数和血清铁蛋白筛查。婴儿被分为两组。[第1组（铁缺乏），[第1a组：缺铁（ID），第1b组：缺铁性贫血（IDA）]，第2组（铁充足（IS）]。122名（24.3%）婴儿被诊断为贫血。110名（90.2%）贫血婴儿观察到小红细胞症。第2组占49.5%（n = 248），而152名（30.3%）和101名（20.2%）婴儿分别属于第1a组和第1b组。多因素逻辑回归分析表明，男性（OR = 1.53；95%CI为1.07和2.17）、每天饮用超过500毫升牛奶（OR = 2.77；95%CI为0.87和8.83）以及未按要求补充铁剂（OR = 2.51；95%CI为1.75和3.60）是第1组的显著特征，而食用配方奶较少的婴儿铁缺乏症患病率较高（OR = 3.10；95%CI为2.00和4.80）。未按要求补充铁剂最常见的原因是认为补充不必要（n = 69，31.1%）和疏忽（n = 59，26.6%）。我们的研究表明，在采用国家铁补充剂的环境中，婴儿铁缺乏症发生率较高，且未按要求补充铁剂是铁缺乏症最明显的风险因素。医疗保健提供者对家庭进行关于遵守铁预防措施重要性的有效咨询对于预防铁缺乏症至关重要。我们还建议在铁缺乏症发生率高的环境中对婴儿进行缺铁和缺铁性贫血筛查。
