Bayoumi Imaan, Parkin Patricia C, Lebovic Gerald, Patel Rupa, Link Kendra, Birken Catherine S, Maguire Jonathon L, Borkhoff Cornelia M
Department of Family Medicine, Queen's University, 220 Bagot St., P.O. Bag 8888, Kingston, ON, K7L5E9, Canada.
Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada.
BMC Fam Pract. 2018 Sep 24;19(1):161. doi: 10.1186/s12875-018-0848-9.
Iron deficiency in early childhood has been associated with poor developmental outcomes. Little is known about the nutritional health of young children receiving care at Canadian Community Health Centres (CHCs). Our objectives were to describe iron deficiency among toddlers at an Ontario CHC, to compare young children attending CHCs and non-CHCs, and assess the feasibility of conducting research on children in CHC settings.
One CHC, Kingston Community Health Centres (CHC) with two clinical sites and one community programming site was added to the nine non-CHC pediatric and primary care clinics in the existing TARGet Kids! research network. A cross-sectional feasibilitystudy was conducted.and. Healthy children, ages 12-36 months were Enrolled. iron deficiency without inflammation (ferritin< 14 μg/L and CRP < 10 mg/L) and serum ferritin were assessed. Adjusted multivariable regression analyses were used to evaluate an association between CHC enrolment and iron status.
The CHC cohort (n = 31) was older, had lower household income, lower maternal education, higher nutrition risk scores, higher cow's milk intake, shorter breastfeeding duration and higher prevalence of unhealthy weights compared with the non-CHC cohort (n = 875). There was no association between CHC status and serum ferritin (difference in median serum ferritin 4.78 μg/L, 95% confidence interval [CI] -2.5, 14.3, p = 0.22) or iron deficiency (OR 0.55, 95% CI 0.11, - 2.73, p = 0.46) using multivariable linear and logistic regression, respectively.
Despite differences in sociodemographic variables, we did not detect a difference in iron status between toddlers enrolled at CHCs compared to non-CHC settings. Further research is needed to understand the health effects of poverty generally, and iron deficiency specifically among children receiving care at CHCs.
幼儿期缺铁与不良发育结局有关。对于在加拿大社区健康中心（CHC）接受护理的幼儿的营养健康状况知之甚少。我们的目标是描述安大略省一家社区健康中心幼儿的缺铁情况，比较在社区健康中心和非社区健康中心就诊的幼儿，并评估在社区健康中心环境中对儿童进行研究的可行性。
在现有的“目标儿童”研究网络中的9家非社区健康中心儿科和初级保健诊所基础上，增加了一家社区健康中心，即金斯顿社区健康中心（CHC），该中心有两个临床站点和一个社区规划站点。进行了一项横断面可行性研究。纳入了12至36个月的健康儿童。评估了无炎症的缺铁情况（铁蛋白<14μg/L且CRP<10mg/L）和血清铁蛋白。采用调整后的多变量回归分析来评估社区健康中心登记与铁状态之间的关联。
与非社区健康中心队列（n = 875）相比，社区健康中心队列（n = 31）年龄更大，家庭收入更低，母亲受教育程度更低，营养风险评分更高，牛奶摄入量更高，母乳喂养持续时间更短，不健康体重的患病率更高。分别使用多变量线性回归和逻辑回归分析，社区健康中心状态与血清铁蛋白（血清铁蛋白中位数差异为4.78μg/L，95%置信区间[CI] -2.5，14.3，p = 0.22）或缺铁情况（OR 0.55，95%CI 0.11，-2.73，p = 0.46）之间均无关联。
尽管社会人口统计学变量存在差异，但我们未发现社区健康中心登记的幼儿与非社区健康中心环境中的幼儿在铁状态方面存在差异。需要进一步研究以了解贫困对健康的总体影响，特别是缺铁对在社区健康中心接受护理的儿童的影响。
