Screening and Routine Supplementation for Iron Deficiency Anemia: A Systematic Review

McDonagh, Marian; Blazina, Ian; Dana, Tracy; Cantor, Amy; Bougatsos, Christina

doi:10.1542/peds.2014-3979

Cited by 66 publications

(58 citation statements)

References 39 publications

(96 reference statements)

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“…Sequelae from IDA include long‐term neurocognitive deficits, fatigue, pica, and in severe cases high‐output heart failure or stroke . Much attention has focused on prevention and early diagnosis of IDA, yet little research has assessed treatment and follow‐up of those children in whom IDA is diagnosed in spite of preventive strategies …”

Section: Introductionmentioning

confidence: 99%

Deficiencies in the Management of Iron Deficiency Anemia During Childhood

Powers

Daniel

McCavit

et al. 2016

Pediatric Blood & Cancer

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Limited high quality evidence supports the management of iron deficiency anemia (IDA). To assess our institutional performance in this area we retrospectively reviewed IDA treatment practices in 195 consecutive children referred to our center from 2006 to mid–2010. The majority were ≤4 years old (64%) and had nutritional IDA (74%). In 11 to 18 year old patients (31%), the primary etiology was menorrhagia (42%). Many were referred directly to the emergency department and/or prescribed iron doses outside the recommended range. Poor medication adherence and being lost to follow-up were common. Substantial improvements are required in the management of IDA.

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Section: Introductionmentioning

confidence: 99%

Deficiencies in the Management of Iron Deficiency Anemia During Childhood

Powers

Daniel

McCavit

et al. 2016

Pediatric Blood & Cancer

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“…The effects on neurodevelopment are less consistent or pronounced in such trials versus in studies that compare neurodevelopment in infants with or without iron deficiency. In fact, some meta-analyses conclude that there are no effects of iron supplementation, 31,32 in contrast to several studies showing poorer outcomes in iron-deficient infants. 24, 33 -36 Additional considerations help us understand this apparent paradox.…”

Section: Iron As An Example Of Nutrient Defi Cits and Impaired Neurodmentioning

confidence: 95%

Neurodevelopment: The Impact of Nutrition and Inflammation During Infancy in Low-Resource Settings

2017

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Infancy and early childhood (ie, birth through age 24 months) represent a period of life with both exquisite opportunity and vulnerability for neurodevelopment. This is due to rapid brain development, both anatomic and functional, as well as to high nutrient requirements during a time of dependence on human milk and complementary foods. Complex interactions exist among nutrition, social, and physical environments and exposures. The newborn brain also reflects maternal exposures that occurred as the product of many interacting forces during gestation. Connections between nutrient use and acute and chronic inflammation are increasingly recognized, but the evidence base linking both nutrition and inflammation to neurodevelopment is relatively modest and quite limited for this young age group specifically. This article provides an overview of key interactions of nutritional requirements relevant to brain development and function; nutritional vulnerabilities related to maternal nutritional status and function; and the impact of environmental exposures and inflammation on nutrient homeostasis and neurodevelopment during this critical developmental window.

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“…In this case, discordant results for supplemental iron and GDM from observational studies and RCT. 6 supplementation, the USPSTF considered as possible health outcomes maternal and child mortality and morbidity; birth outcomes, such as preterm birth and low birth weight; growth; developmental (cognitive, neurodevelopmental delay, psychomotor) outcomes; and quality of life ( Figure 1). Other maternal health outcomes, such as cognition and depression, have not been considered and were not discussed during the workshop but are also potential outcomes to assess.…”

Section: Linking Iron Status To Maternal and Infant Health Outcomes Bmentioning

confidence: 99%

“…The health outcomes used in the USPSTF review are exemplified in the adapted analytic framework (Figure 1) from the systematic reviews that informed the USPSTF deliberations (5,6). Importantly, these outcomes did not include hematologic measures, such as hemoglobin and serum ferritin (SF), which they considered as intermediate outcomes that have not been linked to relevant clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Integrating themes, evidence gaps, and research needs identified by workshop on iron screening and supplementation in iron-replete pregnant women and young children

Brannon

Stover

Taylor

2017

The American Journal of Clinical Nutrition

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This report addresses the evidence and the uncertainties, knowledge gaps, and research needs identified by participants at the NIH workshop related to iron screening and routine iron supplementation of largely iron-replete pregnant women and young children (6-24 mo) in developed countries. The workshop presentations and panel discussions focused on current understanding and knowledge gaps related to iron homeostasis, measurement of and evidence for iron status, and emerging concerns about supplementing iron-replete members of these vulnerable populations. Four integrating themes emerged across workshop presentations and discussion and centered on 1) physiologic or developmental adaptations of iron homeostasis to pregnancy and early infancy, respectively, and their implications, 2) improvement of the assessment of iron status across the full continuum from iron deficiency anemia to iron deficiency to iron replete to iron excess, 3) the linkage of iron status with health outcomes beyond hematologic outcomes, and 4) the balance of benefit and harm of iron supplementation of iron-replete pregnant women and young children. Research that addresses these themes in the context of the full continuum of iron status is needed to inform approaches to the balancing of benefits and harms of screening and routine supplementation.Am J Clin Nutr 2017;106(Suppl):1703S-12S.

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Screening and Routine Supplementation for Iron Deficiency Anemia: A Systematic Review

Cited by 66 publications

References 39 publications

Deficiencies in the Management of Iron Deficiency Anemia During Childhood

Deficiencies in the Management of Iron Deficiency Anemia During Childhood

Neurodevelopment: The Impact of Nutrition and Inflammation During Infancy in Low-Resource Settings

Integrating themes, evidence gaps, and research needs identified by workshop on iron screening and supplementation in iron-replete pregnant women and young children

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