title: Screening and routine supplementation for iron deficiency anemia: a systematic review.
abstract: OBJECTIVE
  Supplementation and screening for iron-deficiency anemia (IDA) in young children may improve growth and development outcomes. The goal of this study was to review the evidence regarding the benefits and harms of screening and routine supplementation for IDA for the US Preventive Services Task Force.
  
  
  METHODS
  We searched Medline and Cochrane databases (1996-August 2014), as well as reference lists of relevant systematic reviews. We included trials and controlled observational studies regarding the effectiveness and harms of routine iron supplementation and screening in children ages 6 to 24 months conducted in developed countries. One author extracted data, which were checked for accuracy by a second author. Dual quality assessment was performed.
  
  
  RESULTS
  No studies of iron supplementation in young children reported on the diagnosis of neurodevelopmental delay. Five of 6 trials sparsely reporting various growth outcomes found no clear benefit of supplementation. After 3 to 12 months, Bayley Scales of Infant Development scores were not significantly different in 2 trials. Ten trials assessing iron supplementation in children reported inconsistent findings for hematologic measures. Evidence regarding the harms of supplementation was limited but did not indicate significant differences. No studies assessed the benefits or harms of screening or the association between improvement in impaired iron status and clinical outcomes. Studies may have been underpowered, and control factors varied and could have confounded results.
  
  
  CONCLUSIONS
  Although some evidence on supplementation for IDA in young children indicates improvements in hematologic values, evidence on clinical outcomes is lacking. No randomized controlled screening studies are available.
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon mcdonagh@ohsu.edu.
authors.forename: Marian S
authors.initials: MS
authors.lastname: McDonagh
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon.
authors.forename: Ian
authors.initials: I
authors.lastname: Blazina
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon.
authors.forename: Tracy
authors.initials: T
authors.lastname: Dana
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon.
authors.forename: Amy
authors.initials: A
authors.lastname: Cantor
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon.
authors.forename: Christina
authors.initials: C
authors.lastname: Bougatsos
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D002657:Child Development / Q000187:drug effects; D018849:Controlled Clinical Trials as Topic; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D058085:Iron Compounds; D008297:Male; D008403:Mass Screening; D064887:Observational Studies as Topic; D016896:Treatment Outcome
chemical_list: D058085:Iron Compounds
keywords: guidelines; iron-deficiency anemia; systematic review