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Original article

Vol. 144 No. 5152 (2014)

Iron deficiency in infancy: is an immigrant more at risk?

  • Marie-Elise Verga
  • Véronique Widmeier-Pasche
  • Maja Beck Popovic
  • Jean-Yves Pauchard
  • Mario Gehri
DOI
https://doi.org/10.4414/smw.2014.14065
Cite this as:
Swiss Med Wkly. 2014;144:w14065
Published
15.12.2014

Summary

QUESTIONS UNDER STUDY: Iron deficiency with or without anaemia is the most common deficiency in the world. Its prevalence is higher in developing countries and in low socioeconomic populations. We aimed at determining and comparing the prevalence of iron deficiency in an immigrant and non-immigrant population.

METHODS: Every child scheduled for a routine check-up at 12 months of age was allowed to participate in the study. Haemoglobin, ferritin, anthropometric data, familial and nutritional status were measured.

RESULTS: 586 infants were eligible and 463 were included in the study as they had assessment data at 12 months. Children were divided into two groups: immigrants’ children and non-immigrants’ children. The global prevalence of iron deficiency was 5.7% at 12 months. A significant difference for iron deficiency was noticed between the groups at 12 months (p = 0.01). Among risk factors, immigration (odds ratio 2.91; 95% CI 1.05–8.04) and unemployment (odds ratio 6.08; 95% CI 1.18–31.30) had the higher odds in the multivariable analysis.

CONCLUSION: The prevalence of iron deficiency in the immigrant population is higher than in non-immigrants. Immigration and the category of employment are risk factors for iron deficiency, as starting baby cereals before 9 months is a protective factor. Good socioeconomic conditions in Switzerland, the quality of food for pregnant women and young infants may be the explanation. A study up to five years of age is necessary before drawing general conclusions on infancy.

References

  1. Looker AC, Dallman PR, Carroll MD, et al. Prevalence of iron deficiency in the United States. JAMA: the journal of the American Medical Association. 1997;277(12):973–6.
  2. Centers for Disease C, Prevention. Iron deficiency – United States, 1999–2000. MMWR Morbidity and mortality weekly report. 2002;51(40):897–9.
  3. Who/Cdc. Assessing the iron status of populations: report of a Joint World Health Organization / Centres for Disease Control and Prevention Technical Consultation on the assessment of iron status at the population level. Geneva, Switzerland 2005.
  4. Oski FA. Iron deficiency in infancy and childhood. N Engl J Med. 1993;329(3):190–3.
  5. Zlotkin S. Clinical nutrition: 8. The role of nutrition in the prevention of iron deficiency anemia in infants, children and adolescents. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2003;168(1):59–63.
  6. Boutry M, Needlman R. Use of diet history in the screening of iron deficiency. Pediatrics. 1996;98(6 Pt 1):1138–42.
  7. Idjradinata P, Pollitt E. Reversal of developmental delays in iron-deficient anaemic infants treated with iron. Lancet. 1993;341(8836):1–4.
  8. Lozoff B, Jimenez E, Wolf AW. Long-term developmental outcome of infants with iron deficiency. N Engl J Med. 1991;325(10):687–94.
  9. Lukowski AF, Koss M, Burden MJ, et al. Iron deficiency in infancy and neurocognitive functioning at 19 years: evidence of long-term deficits in executive function and recognition memory. Nutr Neurosci. 2010;13(2):54–70.
  10. Pisacane A, De Vizia B, Valiante A, et al. Iron status in breast-fed infants. J Pediatr. 1995;127(3):429–31.
  11. Carter RC, Jacobson JL, Burden MJ, et al. Iron deficiency anemia and cognitive function in infancy. Pediatrics. 2010;126(2):e427–34.
  12. Falkingham M, Abdelhamid A, Curtis P, et al. The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis. Nutrition journal. 2010;9:4.
  13. Aggett PJ, Agostoni C, Axelsson I, et al. Iron metabolism and requirements in early childhood: do we know enough?: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2002;34(4):337–45.
  14. Bamberg R. Occurrence and detection of iron-deficiency anemia in infants and toddlers. Clinical laboratory science: journal of the American Society for Medical Technology. 2008;21(4):225–31.
  15. Beard J. Recent evidence from human and animal studies regarding iron status and infant development. J Nutr. 2007;137(2):524S–30S.
  16. Grant CC, Wall CR, Wilson C, et al. Risk factors for iron deficiency in a hospitalized urban New Zealand population. J Paediatr Child Health. 2003;39(2):100–6.
  17. Kahigwa E, Schellenberg D, Sanz S, et al. Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case-control study. Tropical medicine & international health: TM & IH. 2002;7(10):823–30.
  18. Yang Z, Lonnerdal B, Adu-Afarwuah S, et al. Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age: comparison of data from 6 studies. Am J Clin Nutr. 2009;89(5):1433–40.
  19. Ayala GX, Baquero B, Klinger S. A systematic review of the relationship between acculturation and diet among Latinos in the United States: implications for future research. J Am Diet Assoc. 2008;108(8):1330–44.
  20. Popovic-Lipovac A, Strasser B. A Review on Changes in Food Habits Among Immigrant Women and Implications for Health. Journal of immigrant and minority health / Center for Minority Public Health. 2013 Jul 28.
  21. Mata Codesal D. Eating abroad, remembering (at) home. Anthropology of food [online]. 2010;7 | December 2010.
  22. Cusick SE, Mei Z, Freedman DS, et al. Unexplained decline in the prevalence of anemia among US children and women between 1988–1994 and 1999–2002. Am J Clin Nutr. 2008;88(6):1611–7.
  23. Male C, Persson LA, Freeman V, et al. Prevalence of iron deficiency in 12–mo-old infants from 11 European areas and influence of dietary factors on iron status (Euro-Growth study). Acta Paediatr. 2001;90(5):492–8.
  24. Brotanek JM, Gosz J, Weitzman M, et al. Iron deficiency in early childhood in the United States: risk factors and racial/ethnic disparities. Pediatrics. 2007;120(3):568–75.
  25. Brotanek JM, Halterman JS, Auinger P, et al. Iron deficiency, prolonged bottle-feeding, and racial/ethnic disparities in young children. Arch Pediatr Adolesc Med. 2005;159(11):1038–42.
  26. Gehri M, Hunziker B, Geraud F, et al. Migrant populations at the Hopital de l’Enfance of Lausanne (HEL): evaluation inquiry, taking care and contribution of cultural mediators-translators. Sozial- und Praventivmedizin. 1999;44(6):264–71.
  27. Niessen J, Huddleston T. Setting up a system of benchmarking to measure the success of integration policies in Europe. Brussels, European Parliament: The European Parliament’s committee on Civil Liberties Justice and Home Affairs; 2007. Report No.: IP/C/LIBE/ST/2005–93.
  28. Goodmann SW. Naturalisation Policies in Europe: Exploring Patterns of Inclusion and Exclusion. San Domenico di Fiesole (FI), Italy: EUDO Citizenship Observatory, Robert Schuman Centre for Advanced Studies; 2010. Report No.: Comparative Report, RS CAS/EUDO-CIT-Comp.2010/7.
  29. Largo RH, Pfister D, Molinari L, et al. Significance of prenatal, perinatal and postnatal factors in the development of AGA preterm infants at five to seven years. Dev Med Child Neurol. 1989;31(4):440–56.
  30. Brotanek JM, Gosz J, Weitzman M, et al. Secular trends in the prevalence of iron deficiency among US toddlers, 1976–2002. Arch Pediatr Adolesc Med. 2008;162(4):374–81.
  31. (Scris). Population étrangère selon la nationalité et le type de permis de résidence, Commune de Lausanne, 2000 2000 [Accessed; Available from: http://www.scris-lausanne.vd.ch/Default.aspix?DomID=1597
  32. Hercberg S, Preziosi P, Galan P. Iron deficiency in Europe. Public health nutrition. 2001;4(2B):537–45.
  33. Unesco. Accessed 10 October 2012; Available from: http://www.unesco.org/new/en/social-and-human-sciences/themes/international-migration/glossary/migrant/
  34. Rivera JA, Shamah T, Villalpando S, et al. Effectiveness of a large-scale iron-fortified milk distribution program on anemia and iron deficiency in low-income young children in Mexico. Am J Clin Nutr. 2010;91(2):431–9.
  35. Roville-Sausse F, Prado Martinez C. Alimentation et santé des femmes migrantes chinoises et de leurs enfants en Europe occidentale: l’exemple de la France et de l’Espagne (Food and Health of the Chinese migrant women and their children in West Europe: the example of France and Spain). Anthrop. 2009(19):47–56.
  36. Dedaire M, Tozanli S. Les paradoxes des distances dans la construction des identités alimentaires par acculturation (Paradoxes of acculturation process that arise during the identity (re)constructionin the field of food consumption and eating habits). Anthropology of food [online]. 2007;S3 | December 2007.
  37. Goddard AF, James MW, Mcintyre AS, et al. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60(10):1309–16.

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