Incidence of iron‐deficiency anaemia in infants in a prospective study in Jordan

Abstract

A high prevalence of iron-deficiency anaemia has been reported in Jordanian infants. A prospective study of infants in downtown Amman examined the relationship between anaemia in pregnancy and iron deficiency in infancy. The iron status of infants born to 107 anaemic (Hb < 11 g/dl) and 125 non-anaemic mothers was reviewed at 3, 6, 9 and 12 months. Indicators to define iron-deficiency anaemia were Hb < 11 g/dl and either plasma ferritin < 12 microg/l or zinc protoporphyrin (ZPP) > 35 microg/dl whole blood. Haemoglobin electrophoresis excluded haemoglobinopathy. There was 72% iron-deficiency anaemia throughout the year, significantly higher in infants born to anaemic mothers (81%; n = 91) compared with controls (65%; n = 112). At 12 months, 72% of the infants tested (n = 195) were anaemic. While 57% were identified as iron-deficient by research criteria of either ferritin or ZPP, only 37% were identified by ferritin alone, 40% by ZPP alone and 29% if both ferritin and ZPP were required to meet criteria. Most infant anaemia was identified as due to iron deficiency, supporting contextual setting as assisting diagnosis: infants in developing countries are recognised as vulnerable to iron deficiency. Using multiple criteria, more cases were identified when either ferritin or ZPP were abnormal than when one alone, or both parameters were required to meet research criteria.

The Incidence of Anemia in an Israeli Population: A Population Analysis for Anemia in 34512 Israeli Infants Aged 9 to 18 Months

“…24 Another study from Jordan reported a higher frequency of anemia, at 72%. 25 One of the most common causes of anemia in infants is prematurity. The percentage of premature infants in the Israeli population is 8.4% of live births, 8.7% in the Jewish population, and 7.7% in the non-Jewish population.…”

Relationship between the iron status of pregnant women and their newborns

“…It has been currently discussed whether maternal iron nutritional status has an impact or not on the iron status of their children at birth and throughout childhood. 10,11,13,14,21,22,24 It is known that the fetus receives iron indirectly from the maternal circulation through a rapid and unidirectional process. Maternal iron is transported to the placenta bound to a protein, maternal transferrin, which does not cross the placenta, transferring this mineral element to placental receptors.…”

“…Other investigators also did not fi nd signifi cant differences between children born to anemic or iron-defi cient pregnant women and those born to normal pregnant women. [9][10][11]13,18 In a case-control study carried out in Jordan, Kilbride et al 11 investigated the relationship between maternal anemia and iron status of newborns at birth (umbilical cord) and at 3-4, 6, 9 and 12 months of age. The authors found that iron content in cord blood was similar in anemic and control pregnant women, with no signifi cant difference in hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration or plasma ferritin.…”

Unexpectedly high early prevalence of anaemia in 6-month-old breast-fed infants in rural Bangladesh

“…In fact, daily Fe supplementation (12?5 mg of elemental Fe) is recommended for all infants between the ages of 6 and 24 months in areas where the prevalence of anaemia exceeds 40 % (9) . Compared with infants in developed countries, it has been observed that anaemia may be prevalent at or before 6 months of age in infants in developing countries (10)(11)(12) . For example, high anaemia (defined as Hb , 110 g/l) prevalence was documented at 6 months of age in infants in Jordan and Israel (63 % and 44 %, respectively) (10,11) .…”

“…Compared with infants in developed countries, it has been observed that anaemia may be prevalent at or before 6 months of age in infants in developing countries (10)(11)(12) . For example, high anaemia (defined as Hb , 110 g/l) prevalence was documented at 6 months of age in infants in Jordan and Israel (63 % and 44 %, respectively) (10,11) . Additionally, a 42 % prevalence of anaemia has been documented in 4-month-old infants in a recent study in Benin (12) .…”