Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age: Comparison of data from 6 studies

Zhenyu Yang, Bo Lönnerdal, Seth Adu-Afarwuah, Kenneth H. Brown, Camila M. Chaparro, Roberta J. Cohen, Magnus Domellöf, Olle Hernell, Anna Lartey, Kathryn G. Dewey

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Abstract

Background: Iron deficiency (ID) can occur among exclusively breastfed infants before 6 mo of age. Objective: The objective was to determine which subgroups of fully breastfed infants are at highest risk of ID. Design: We assessed the prevalence of ID (ferritin < 12 μg/L) and iron deficiency anemia (IDA; ferritin < 12 μg/L and hemoglobin , 105 g/L) and risk factors associated with ID and IDA at 6 mo among 404 fully breastfed infants with a birth weight >2500 g from 6 studies in Ghana, Honduras, Mexico, and Sweden. Infants with an elevated C-reactive protein concentration (8%) were excluded. Results: The percentages of infants with ID were 6% in Sweden, 17% in Mexico, 13-25% in Honduras, and 12-37% in Ghana. The percentages with IDAwere 2% in Sweden, 4% in Mexico, 5-11% in Honduras, and 8-16% in Ghana. With data pooled, the key predictors of ID (20%) were male sex [adjusted odds ratio (AOR): 4.6; 95% CI: 2.5, 8.5] and birth weight 2500-2999 g (AOR: 2.4; 95% CI: 1.4, 4.3). The predictors of IDA (8%) were male sex (AOR: 7.6; 95% CI: 2.5, 23.0), birth weight of 2500-2999 g (AOR: 3.4; 1.5, 7.5), and weight gain above the median since birth (AOR: 3.4; 95% CI: 1.3, 8.6). The combination of birth weight 2500-2999 g or male sex had a sensitivity of 91% for identifying ID and of 97% for identifying IDA. Conclusions: Among fully breastfed infants with a birth weight>2500 g, IDA is uncommon before 6 mo, but male infants and those with a birth weight of 2500-2999 g are at higher risk of ID and IDA.

Original languageEnglish (US)
Pages (from-to)1433-1440
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume89
Issue number5
DOIs
StatePublished - Jan 5 2009

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Iron
Birth Weight
Honduras
Odds Ratio
Ghana
Mexico
Sweden
Ferritins
C-Reactive Protein
Weight Gain
Parturition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Yang, Z., Lönnerdal, B., Adu-Afarwuah, S., Brown, K. H., Chaparro, C. M., Cohen, R. J., ... Dewey, K. G. (2009). Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age: Comparison of data from 6 studies. American Journal of Clinical Nutrition, 89(5), 1433-1440. https://doi.org/10.3945/ajcn.2008.26964

Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age : Comparison of data from 6 studies. / Yang, Zhenyu; Lönnerdal, Bo; Adu-Afarwuah, Seth; Brown, Kenneth H.; Chaparro, Camila M.; Cohen, Roberta J.; Domellöf, Magnus; Hernell, Olle; Lartey, Anna; Dewey, Kathryn G.

In: American Journal of Clinical Nutrition, Vol. 89, No. 5, 05.01.2009, p. 1433-1440.

Research output: Contribution to journalArticle

Yang, Z, Lönnerdal, B, Adu-Afarwuah, S, Brown, KH, Chaparro, CM, Cohen, RJ, Domellöf, M, Hernell, O, Lartey, A & Dewey, KG 2009, 'Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age: Comparison of data from 6 studies', American Journal of Clinical Nutrition, vol. 89, no. 5, pp. 1433-1440. https://doi.org/10.3945/ajcn.2008.26964
Yang, Zhenyu ; Lönnerdal, Bo ; Adu-Afarwuah, Seth ; Brown, Kenneth H. ; Chaparro, Camila M. ; Cohen, Roberta J. ; Domellöf, Magnus ; Hernell, Olle ; Lartey, Anna ; Dewey, Kathryn G. / Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age : Comparison of data from 6 studies. In: American Journal of Clinical Nutrition. 2009 ; Vol. 89, No. 5. pp. 1433-1440.
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AU - Brown, Kenneth H.

AU - Chaparro, Camila M.

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N2 - Background: Iron deficiency (ID) can occur among exclusively breastfed infants before 6 mo of age. Objective: The objective was to determine which subgroups of fully breastfed infants are at highest risk of ID. Design: We assessed the prevalence of ID (ferritin < 12 μg/L) and iron deficiency anemia (IDA; ferritin < 12 μg/L and hemoglobin , 105 g/L) and risk factors associated with ID and IDA at 6 mo among 404 fully breastfed infants with a birth weight >2500 g from 6 studies in Ghana, Honduras, Mexico, and Sweden. Infants with an elevated C-reactive protein concentration (8%) were excluded. Results: The percentages of infants with ID were 6% in Sweden, 17% in Mexico, 13-25% in Honduras, and 12-37% in Ghana. The percentages with IDAwere 2% in Sweden, 4% in Mexico, 5-11% in Honduras, and 8-16% in Ghana. With data pooled, the key predictors of ID (20%) were male sex [adjusted odds ratio (AOR): 4.6; 95% CI: 2.5, 8.5] and birth weight 2500-2999 g (AOR: 2.4; 95% CI: 1.4, 4.3). The predictors of IDA (8%) were male sex (AOR: 7.6; 95% CI: 2.5, 23.0), birth weight of 2500-2999 g (AOR: 3.4; 1.5, 7.5), and weight gain above the median since birth (AOR: 3.4; 95% CI: 1.3, 8.6). The combination of birth weight 2500-2999 g or male sex had a sensitivity of 91% for identifying ID and of 97% for identifying IDA. Conclusions: Among fully breastfed infants with a birth weight>2500 g, IDA is uncommon before 6 mo, but male infants and those with a birth weight of 2500-2999 g are at higher risk of ID and IDA.

AB - Background: Iron deficiency (ID) can occur among exclusively breastfed infants before 6 mo of age. Objective: The objective was to determine which subgroups of fully breastfed infants are at highest risk of ID. Design: We assessed the prevalence of ID (ferritin < 12 μg/L) and iron deficiency anemia (IDA; ferritin < 12 μg/L and hemoglobin , 105 g/L) and risk factors associated with ID and IDA at 6 mo among 404 fully breastfed infants with a birth weight >2500 g from 6 studies in Ghana, Honduras, Mexico, and Sweden. Infants with an elevated C-reactive protein concentration (8%) were excluded. Results: The percentages of infants with ID were 6% in Sweden, 17% in Mexico, 13-25% in Honduras, and 12-37% in Ghana. The percentages with IDAwere 2% in Sweden, 4% in Mexico, 5-11% in Honduras, and 8-16% in Ghana. With data pooled, the key predictors of ID (20%) were male sex [adjusted odds ratio (AOR): 4.6; 95% CI: 2.5, 8.5] and birth weight 2500-2999 g (AOR: 2.4; 95% CI: 1.4, 4.3). The predictors of IDA (8%) were male sex (AOR: 7.6; 95% CI: 2.5, 23.0), birth weight of 2500-2999 g (AOR: 3.4; 1.5, 7.5), and weight gain above the median since birth (AOR: 3.4; 95% CI: 1.3, 8.6). The combination of birth weight 2500-2999 g or male sex had a sensitivity of 91% for identifying ID and of 97% for identifying IDA. Conclusions: Among fully breastfed infants with a birth weight>2500 g, IDA is uncommon before 6 mo, but male infants and those with a birth weight of 2500-2999 g are at higher risk of ID and IDA.

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