Iron deficiency anemia in 1-year-old children of disadvantaged families in Montreal.
OBJECTIVE
To determine the prevalence of iron deficiency anemia among 1-year-old infants of disadvantaged families in Montreal as well as certain predictors of this condition.


METHODS
Cohort study.


METHODS
Five poorest health districts in Montreal.


METHODS
Infants 10 to 14 months of age were identified from registration lists of births from May 1988 to August 1989. Those whose mother had less than 11 years of schooling and a family income below the government-defined low-income cutoff point were eligible.


METHODS
During a home visit capillary blood samples were obtained from the child, and the mother answered a questionnaire about infant-feeding practices. Infants with a serum ferritin level of 10 micrograms/L or less and either a hemoglobin level of 115 g/L or less or a mean corpuscular volume of 72 fL or less were considered as having iron deficiency anemia.


RESULTS
Of the 299 mothers who were eligible and could be located 220 (74%) agreed to participate; 218 blood samples were available. Iron deficiency anemia was found in 25% of the infants (95% confidence interval [CI] 19% to 31%). The mean hemoglobin level was 115 (standard deviation 11) g/L. The serum ferritin level, assessed routinely in the last 62 infants, was 10 micrograms/L or less in 37% of the infants. The factors that were found to be predictors of iron deficiency anemia included the use of whole cow's milk before 6 months of age (odds ratio [OR] 3.56 [95% CI 1.07 to 11.26]) and the use of iron-fortified infant cereal for less than 6 months (OR 3.15 [95% CI 1.25 to 7.96]). A low birth weight and the use of iron-fortified formula for less than 6 months were associated with iron deficiency anemia.


CONCLUSIONS
Despite a decrease in the prevalence of iron deficiency anemia among children of disadvantaged families in the United States socioeconomically disadvantaged infants in Montreal are at risk. Preventive measures must be taken to ensure adequate iron status in the first year of life.
Lehmann
F
F
Department of Family Medicine, Université de Montréal, Que.
Gray-Donald
K
K
Mongeon
M
M
Di Tommaso
S
S
D000747:Anemia, Hypochromic / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D001719:Birth Certificates; D015331:Cohort Studies; D004522:Educational Status; D004909:Erythrocyte Indices; D005247:Feeding Behavior; D005260:Female; D005293:Ferritins / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007182:Income; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000193:education; D011203:Poverty; D011237:Predictive Value of Tests; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D006454:Hemoglobins; D005293:Ferritins