Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain.
BMC Pediatr. 2021 Sep 8;21(Suppl 1):337. doi: 10.1186/s12887-021-02725-w.
We looked at existing recommendations and supporting evidence on the effectiveness of universal screening of iron deficiency anaemia (IDA) in children under five years of age for improving growth, cognitive function, and psychomotor development. We assessed the accuracy of the screening tests for detecting IDA, the efficacy of existing treatment for children with IDA, and the potential harms associated with screening and treatment.We conducted a literature search up to the 18th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.There is no suitable test for IDA screening that is non-invasive with high accuracy for detecting IDA and there is uncertainty whether IDA in children causes cognitive and psychomotor delays. There is a lack of evidence on the effects of routine screening for IDA in asymptomatic children under five years of age on growth, cognitive and psychomotor development outcomes.Universal screening of IDA in children under five years of age is not recommended by most organisations such as the Spanish Association of Primary Care Paediatrics, the United Kingdom National Screening Committee, and the United States Preventive Services Task Force, but is recommended by the American Academy of Paediatrics. However, selective screening of IDA is recommended in infants and children with risk factors including prematurity, low birth weight, and dietary risk factors.
我们研究了现有的关于五岁以下儿童缺铁性贫血(IDA)普遍筛查有效性的建议和支持证据,以评估其对生长、认知功能和运动发育的改善作用。我们评估了筛查试验检测 IDA 的准确性、针对 IDA 患儿的现有治疗效果,以及筛查和治疗相关的潜在危害。
我们于 2019 年 8 月 18 日之前使用关键词和选定来源的手动搜索进行了文献检索。我们总结了作者报告的建议及其推荐强度。我们按照报告的证据确定性对系统评价的主要结果进行了总结。
目前没有适合的 IDA 筛查方法,既非侵入性,又具有高度准确性来检测 IDA,而且对于儿童 IDA 是否导致认知和运动发育迟缓,也存在不确定性。对于五岁以下无症状儿童常规筛查 IDA 对生长、认知和运动发育结果的影响,目前也缺乏证据。
西班牙初级保健儿科学会、英国国家筛查委员会和美国预防服务工作组等大多数组织均不推荐五岁以下儿童进行 IDA 普遍筛查,但美国儿科学会推荐这样做。但是,对于有早产、低出生体重和饮食相关危险因素的婴儿和儿童,建议选择性筛查 IDA。