title: Iron status of young children from immigrant families.
abstract: OBJECTIVE
  Children from immigrant families may be at risk for iron deficiency (ID) due to differences in pre-migration and post-migration exposures. Our objectives were to determine whether there is an association between family immigrant status and iron stores and to evaluate whether known dietary, environmental or biological determinants of low iron status influence this relationship.
  
  
  METHODS
  This was a cross-sectional study of healthy urban preschool children (12-72 months) recruited from seven primary care practices in Toronto. Laboratory assessment of serum ferritin and haemoglobin and standardised parent-completed surveys were completed between 2008 and 2013 during routine health maintenance visits. Multiple regression analyses were used to evaluate the association between family immigrant status and serum ferritin, ID (ferritin <14 μg/L) and iron deficiency anaemia (IDA) (ferritin <14 μg/L and haemoglobin ≤110 g/L).
  
  
  RESULTS
  Of 2614 children included in the analysis, 47.6% had immigrant family status. The median serum ferritin was 30 μg/L and 10.4% of all children had ID and 1.9% had IDA. After adjusting for maternal ethnicity and education, age, sex, income quintile, cow's milk intake, breastfeeding duration and bottle use, there were no significant associations between immigrant status and ferritin, ID or IDA. Significant predictors of low iron status included age, sex, cow's milk intake and breastfeeding duration.
  
  
  CONCLUSIONS
  We found no association between family immigrant status and iron status after including clinically important covariates in the models. These data suggest immigrant children may not need enhanced screening for iron status or targeted interventions for iron supplementation.
authors: Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Natasha Ruth
authors: NR
authors: Saunders
authors: Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario, Canada.|Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
authors: Patricia C
authors: PC
authors: Parkin
authors: Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario, Canada.|Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
authors: Catherine S
authors: CS
authors: Birken
authors: Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario, Canada.|Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.|Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.|Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada.
authors: Jonathon L
authors: JL
authors: Maguire
authors: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario, Canada.|Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.|Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
authors: Cornelia M
authors: CM
authors: Borkhoff
mesh_terms: D017677:Age Distribution; D001208:Asia / Q000208:ethnology; D001942:Breast Feeding / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D000090463:Iron Deficiencies; D009864:Ontario / Q000453:epidemiology; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014504:Urban Health
chemical_list: D005293:Ferritins
keywords: Evidence Based Medicine; General Paediatrics; Nutrition; Paediatric Practice; Race and Health