James J, Evans J, Male P, Pallister C, Hendrikz J K, Oakhill A
J R Coll Gen Pract. 1988 Jun;38(311):250-2.
Iron deficiency in children has been associated with behavioural disorder and developmental delay. Screening for iron deficiency was offered to all 527 children aged between one and four years in an inner city practice. Half the children belong to an ethnic minority group, and there is widespread social deprivation in the area. Capillary haemoglobin concentration and mean corpuscular volume were estimated in 365 children (69%). Dietary history, birth weight and current weight were also recorded. Fifty-eight (16%) of the children were iron deficient as defined by a mean corpuscular volume of less than 75 fl and/or a haemoglobin concentration of less than 10.5 g dl(-1). All were hypochromic and among 23 tested all had serum ferritin levels below 10microg I(-1). Twenty-one children (5.8%) were anaemic (haemoglobin concentration less than 10.5 g dl(-1)). Anaemia was significantly more common among children who were currently underweight but was not related to weight at birth. Iron deficiency was significantly more prevalent in non-Caucasian children - 25.0% compared with 7.8% of Caucasian children. There was also a significant linear decrease in iron deficiency with increasing age. Sex, weight at birth, current weight, whether breast fed, age weaned or whether on a vegetarian diet were not significant factors in iron deficiency. Iron supplements were given to all the children with iron deficiency.In view of the high prevalence of iron deficiency, all children in the practice are now routinely offered screening for iron deficiency at the age of 14 months. The programme has been welcomed by all parents. It is suggested that screening for iron deficiency should be part of routine child surveillance.
儿童缺铁与行为障碍和发育迟缓有关。在市中心的一家诊所对所有527名年龄在1至4岁之间的儿童进行了缺铁筛查。一半的儿童属于少数族裔群体，该地区存在广泛的社会贫困现象。对365名儿童（69%）进行了毛细血管血红蛋白浓度和平均红细胞体积的评估。还记录了饮食史、出生体重和当前体重。根据平均红细胞体积小于75飞升和/或血红蛋白浓度低于10.5克/分升（-1）的定义，58名（16%）儿童缺铁。所有儿童均为低色素性贫血，在接受检测的23名儿童中，所有儿童的血清铁蛋白水平均低于10微克/升（-1）。21名儿童（5.8%）贫血（血红蛋白浓度低于10.5克/分升（-1））。贫血在目前体重过轻的儿童中更为常见，但与出生体重无关。缺铁在非白种儿童中更为普遍——25.0%，而白种儿童中为7.8%。随着年龄的增长，缺铁也呈显著线性下降。性别、出生体重、当前体重、是否母乳喂养、断奶年龄或是否为素食饮食都不是缺铁的显著因素。对所有缺铁儿童都给予了铁补充剂。鉴于缺铁的高患病率，该诊所现在对所有14个月大的儿童常规进行缺铁筛查。该项目受到了所有家长的欢迎。建议缺铁筛查应成为儿童常规监测的一部分。
