Incidence and Risk Factors of Iron Deficiency Anemia in Term Infants(cid:31)
Supapan Tantracheewathorn MD*, Sirin Lohajaroensub MSc**
Affiliation : (cid:31) Presented at the 57th Thai Congress of Pediatrics, Surat Thani, Thailand, April 21-23, 2004 * Department of Pediatrics, Bangkok Metropolitan Administration Medical College and Vajira Hospital ** Medical Laboratory Department, Bangkok Metropolitan Administration Medical College and Vajira Hospital
Objective : To compare the incidence of iron deficiency anemia (IDA) between breast-fed (BF) and formula-
fed (FF) infants and to identify the risk factors of IDA in these infants.
Design : Cohort study.
Materials and Methods : A study of 140 full- term infants (70 BF and 70 FF) was conducted at BMA Medical
College and Vajira Hospital from February 2002 to November 2003. All infants were followed at the age of
1, 2, 4, 6, 9 and 12 months for growth and developmental assessment. Blood samples were analyzed for
hemoglobin (Hb), hematocrit (Hct) and mean corpuscular volume (MCV) at 9-12 months; and infants with
Hb < 11.0 g/dl were further investigated for the cause of anemia.
Results : The mean values of Hb, Hct, MCV and serum ferritin of BF infants were 10.8 g/dl, 32.8%, 70.9 fl and
16.7 ng/ml respectively, which were significantly lower than those of FF infants (11.4 g/dl, 35.1%, 73.3 fl, and
36.9 ng/ml, p < 0.05). Anemia was found in 27 BF infants (38.6%) compared with 10 FF infants (14.3%). The
incidence of IDA in BF infants was significantly higher than FF infants (25.7% vs 2.9%, p < 0.001). Risk
factors of IDA included low birth weight, breastfeeding and inadequate complementary food (adjusted RR
(95% CI): 3.1(1.1-9.1), 6.3(1.5-25.0), 7.7(2.8-20.0), respectively).
Conclusion : IDA is more prevalent in BF than FF infants. Risk factors of IDA are low birth weight, breastfeeding
and inadequate complementary food. Prevention of IDA in infants should be achieved through adequate
iron-rich complementary food and screening for Hb or Hct at 9-12 months of age in high risk infants.
Keywords : Anemia, Breastfeeding, Formula feeding, Infant, Iron deficiency anemia
