OBJECTIVETo collect epidemiological data of iron deficiency in Chinese children 7 months to 7 years of age, so more rational strategies of prevention and treatment against iron deficiency can be made.

METHODSAll the 31 provinces, municipalities and autonomous regions in China were first divided into 3 major regions based on geographic location socioeconomic developmental status. Among them, 15 provinces, municipalities and autonomous regions were randomly selected: 6 from the coastal regions, 5 from inland regions and 4 from remote regions. Then, 26 cities/counties were further selected from the 15 provinces, municipalities and autonomous regions. Ultimately, 9118 children aged 7 months to 7 years were selected as study subjects. Hemoglobin (Hb) was measured by cyanmethemoglobin assay, zinc protoporphorin by hemofluorescence assay and serum ferritin by radioimmunoassay.

RESULTSThe prevalence rates of iron depletion (ID) and iron deficiency anemia (IDA) were 32.5% and 7.8% respectively in children 7 months to 7 years in China. The prevalence rates were highest in infants (ID 44.7%, IDA 20.8%), followed by toddlers aged 1 - 3 years (ID 35.9%, IDA 7.8%) and preschoolers aged 4 to 7 years (ID 26.5%, IDA 3.5%), with statistically significant differences (P < 0.01). In countryside, the prevalence rates of ID were 35.8%, 31.0% and 27.6%, and the prevalence rates of IDA were 30.1%, 15.5% and 6.3% for children 7 to 12 months, 1 to 3 years and 4 to 7 years of age, respectively. While Hb measurements averaged (98.8 +/- 9.1) g/L, (98.2 +/- 10.5) g/L and (101.2 +/- 8.6) g/L respectively for the same age groups with IDA. In cities, the corresponding figures were 48.1%, 38.0% and 26.0% for ID, 16.8%, 4.4% and 1.9% for IDA, (101.0 +/- 6.8) g/L, (102.8 +/- 6.9) g/L and (104.2 +/- 4.4) g/L for average Hb measurements. There were statistically significant difference between the overall prevalence rate of iron deficiency in children living in rural areas and that of children in cities (42.0% versus 39.5%, P < 0.01). Obviously, there were significantly more urban children aged 6 months to 3 years suffering from latent iron deficiency than their rural counterparts, while there were more rural children with iron deficiency anemia. The average Hb measurements from each rural children age group with IDA were lower than that of their urban peers (P < 0.01).

CONCLUSIONSID was more prevalent than IDA in each age group in children, suggesting that latent iron deficiency was currently one of the major nutritional problems for Chinese children. The present study also showed that infants were still at higher risk for iron deficiency in spite of rapid socioeconomic development in the last two decades. Urban children were more likely to be inflicted by latent iron deficiency, while rural children were more prone to development of iron deficiency anemia. The susceptibility of rural children to development of iron deficiency anemia may be related to lower socioeconomic status of their families, poor hygienic conditions etc.

Anemia, Iron-Deficiency ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Deficiency Diseases ; epidemiology ; Ferritins ; blood ; Hemoglobins ; analysis ; Humans ; Infant ; Iron ; deficiency ; Prevalence ; Protoporphyrins ; blood ; Rural Population ; Socioeconomic Factors ; Urban Population

BACKGROUNDGrowth and development of infants has been an important topic in pediatrics for a long time. Infants must be provided with food containing all necessary nutrients. Breast milk is believed to be the most desirable natural and cheapest food for well-balanced nutrition. But with the progress in the development of substitute food in developed countries, it is thought that formula milk can meet the requirement for infant growth. During early infancy, growth, as the most sensitive index of health, is therefore a critical component in evaluating the adequacy of breast-feeding, mixed-feeding and formula feeding. Iron status is another important index of infant health. Iron deficiency anemia remains the most prevalent nutritional deficiency index in infants worldwide. This study is to compare infants in Beijing at 4 months who are on three different feeding modes (breast feeding, mixed feeding and formula feeding) in physical changes and iron status. The results may provide new mothers with support in feeding mode selection, which will also be helpful to the China Nutrition Association in feeding mode education.

METHODSThis is a cohort study. One thousand and one normal Beijing infants were followed regularly for 12 months. Body weight and horizontal length were measured. Hemoglobin, red blood cell counts, mean corpuscular volume, mean corpuscular hemoglobin and serum iron were analyzed at 4 months.

RESULTSThe breast feeding percentage in the first 4 months was 47.9%. The feeding mode was not significantly related to maternal delivery age, education, labor pathway nor infant sex (P>0.05). Infant boys and girls exclusively breast-fed from 0 to 4 months had the highest weight at 0-6 months. The anemia rate of breast-fed infant boys at 4 months was the highest.

CONCLUSIONSBreast feeding should be given more emphasis. It is compulsory for new mothers to breast-feed their infants if possible. Social environment should also guarantee the requirement for breast feeding. Furthermore the normal values of hemoglobin, mean corpuscular volume and serum iron, which were originally used to judge children's iron deficiency anemia, might not be optimal for evaluating infants. There might be a need to develop sex-specific cutoff levels of hemoglobin, mean corpuscular volume and serum iron for infants.

Anemia, Iron-Deficiency ; epidemiology ; Breast Feeding ; Child Development ; Erythrocyte Indices ; Hemoglobins ; analysis ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Iron ; blood ; Prevalence

OBJECTIVETo investigate the effect of maternal iron levels in second trimester of pregnancy on the infants' early iron status, explore the relationship between maternal and infant's iron status, and analyze the main factor influencing anemia of the infants.

METHODSTotally 100 couples of mother-baby were followed up from the second trimester of the mothers' pregnancy till the babies were 3 - 5 months old in the Department of Primary Child Care from March 2006 to February 2007. The maternal venous blood samples were collected in the second and the third trimesters and were analyzed for Hb at the same time. The infants' venous blood samples were collected at the end of the follow-up visit and were analyzed for Hb. The values of sTfR of the infants were compared with the maternal iron status diagnostic criteria. The infant's weight was measured during the visits by two professional staff members. The physical growth was assessed with CDC2000 reference.

RESULTS(1) Among 100 couples of mother-baby, none of the Hb values was lower than 90 g/L during the whole period of survey. The prevalence of ID in the babies at the ages of 3-5 months was 39%. Among them 36 cases (36/39, 92.31%) were born to the mother with ID during pregnancy; 26 couples of mother-infant had normal iron status during the following study. (2) The ID' prevalence in the infants born to the mothers with ID was higher than in the babies born to the healthy mothers (chi(2) = 11.567, P < 0.005). The ID' prevalence in the infants born to the mothers with IDA was higher than in the babies born to the mothers with LID (chi(2) = 7.356, P < 0.01). (3) The sTfR values of infants born to the mother with ID during pregnancy were increased significantly (P < 0.01); the iron nutritional status did not show any significant difference between babies whose mothers were IDA and LID (P > 0.05). (4) The SF value of maternal venous blood was negatively correlated with the sTfR value of infant (r = -0.7552, P < 0.01).

CONCLUSIONS(1) The anemia of the infants aged 3 - 5 months was correlated with the iron shortage during the fetal stage. (2) The mild iron deficiency in the pregnant women during the second trimester could decrease the iron storage of fetus and then also could affect the iron status of the early infancy and cause anemia.

Adult ; Anemia, Iron-Deficiency ; epidemiology ; Female ; Fetal Blood ; chemistry ; Humans ; Infant ; Iron ; deficiency ; metabolism ; Maternal Nutritional Physiological Phenomena ; Mothers ; Nutritional Status ; Pregnancy ; Pregnancy Trimester, Second ; Prevalence ; Prospective Studies ; Receptors, Transferrin ; blood ; Young Adult

Anemia, iron deficiency (ID), and iron deficiency anemia (IDA) are common disorders. This study was undertaken to determine the prevalence of anemia, ID, and IDA in Korean females. We examined the associations between IDA, heavy metals in blood, vitamin D level and nutritional intakes. The study was performed using on data collected from 10,169 women (aged > or =10 yr), including 1,232 with anemia, 2,030 with ID, and 690 with IDA during the fifth Korea National Health and Nutrition Examination Survey (KNHANES V; 2010-2012). Prevalence and 95% confidence intervals were calculated, and path analysis was performed to identify a multivariate regression model incorporating IDA, heavy metals in blood, vitamin D level, and nutritional intakes. The overall prevalence of anemia, ID and IDA was 12.4%, 23.11%, and 7.7%, respectively. ID and IDA were more prevalent among adolescents (aged 15-18 yr; 36.5% for ID; 10.7% for IDA) and women aged 19-49 yr (32.7% for ID; 11.3% for IDA). The proposed path model showed that IDA was associated with an elevated cadmium level after adjusting for age and body mass index (beta=0.46, P<0.001). Vitamin D levels were found to affect IDA negatively (beta=-0.002, P<0.001). This study shows that the prevalence of anemia, ID, and IDA are relatively high in late adolescents and women of reproductive age. Path analysis showed that depressed vitamin D levels increase the risk of IDA, and that IDA increases cadmium concentrations in blood. Our findings indicate that systematic health surveillance systems including educational campaigns and well-balanced nutrition are needed to control anemia, ID, and IDA.
Adolescent ; Adult ; Aged ; Anemia, Iron-Deficiency/*blood/*epidemiology ; Body Mass Index ; Cadmium/*blood ; Cross-Sectional Studies ; Female ; Humans ; Immunoradiometric Assay ; Middle Aged ; Nutrition Surveys ; Prevalence ; Regression Analysis ; Republic of Korea/epidemiology ; Risk ; Vitamin D/*blood ; Young Adult

This study assessed the prevalence of, and risk factors for, iron deficiency (ID) and iron deficiency anemia (IDA) among participants of the fifth Korean Health and Nutrition Examination Survey, 2010. Of 8,958 participants, 6,758 individuals > or =10 yr had sufficient data for the analysis of anemia and iron status. ID was defined as a transferrin saturation <10% or serum ferritin <15 microg/L. The prevalence of ID and IDA was 2.0% (95% confidence interval [CI], 1.3%-2.6%) and 0.7% (95% CI, 0.3%-1.0%), respectively, in males, and 22.4% (95% CI, 20.7%-24.2%) and 8.0% (95% CI, 6.8%-9.2%), respectively, in females. In reproductive age females, the prevalence of ID and IDA was 31.4% (95% CI, 28.9%-33.8%) and 11.5% (95% CI, 9.6%-13.4%), respectively. Compared to the prevalence of IDA in adult males 18-49 yr, the relative risks of IDA in adults > or =65 yr, lactating females, premenopausal females, and pregnant females were 8.1, 35.7, 42.8, and 95.5, respectively. Low income, underweight, iron- or vitamin C-poor diets were also associated with IDA. For populations with defined risk factors in terms of age, gender, physiological state and socioeconomic and nutritional status, national health policy to reduce IDA is needed.
Adolescent ; Adult ; Aged ; Anemia, Iron-Deficiency/*epidemiology/pathology ; Child ; Female ; Ferritins/blood ; Food Habits ; Humans ; Lactation ; Male ; Menopause ; Middle Aged ; *Nutrition Surveys ; Pregnancy ; Prevalence ; Republic of Korea ; Risk Factors ; Socioeconomic Factors ; Thinness ; Transferrins/analysis ; Young Adult