Should infants be screened for anaemia? A prospective study investigating the relation between haemoglobin at 8, 12, and 18 months and development at 18 months

Abstract

Aims-To investigate the relation between haemoglobin in children followed longitudinally from 8 to 18 months, and developmental outcome at 18 months. Methods-The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) is a longitudinal survey of a geographically defined population of children born in 1991-92. In a randomly selected subsample, blood samples were assayed for Hb at 8, 12, and 18 months; a developmental assessment was carried out at 18 months on 1141 children using the GriYths Scales of Mental Development. Results-There was a strong quadratic association between Hb at 8 months and performance on the locomotor subscale at 18 months. Average scores increased with increasing Hb up to 95 g/l; there was little additional developmental benefit in Hb levels beyond 95 g/l. Infants with Hb <95 g/l at 8 months of age scored on average 6 points lower on the locomotor subscale than infants with Hb > 95 g/l; infants with Hb <90 g/l at 8 months scored 12 points lower on the locomotor subscale than children with Hb > 90 g/l. Conclusions-Low Hb concentrations (< 95 g/l) in 8 month old children are associated with impaired motor development at 18 months. This cut oV point corresponds to the 5th centile of Hb at 8 months. The results indicate that if there is an adverse eVect of low Hb on developmental outcome, screening may be more eVective at 8 months or earlier, rather than after this age. We propose to examine the importance of infant anaemia in relation to more accurate and detailed long term outcomes as the children get older. (Arch Dis Child 2001;84:480-485)

Haemoglobin Level in Children of a Northern District of Bangladesh

“…However there is significant age specific variation in mean haemoglobin.Significant difference was observed in mean haemoglobin among different age groups(P=0.01). This was noted in other studies also 11,12,13,14 .Age difference and age group variation is well documented by WHO and other studies 1,15 . Other factors influencing mean haemoglobin were family income, occupation of the parent, education of the parents and nutrition status.…”

Parents’ Knowledge and Practice of Iron Therapy for Anemic Infants in Primary Health Care in Bahrain

“…The data collection tool was based on medical references and previous literatures (Al-Alawi F, March 2015;Carter et al, 2010;Hassan et al, 2005;Lozoff et al, 2008;Sherriff A, 2001;Talebi et al, 2012;Williams et al, 1999). The content validity was tested via two pediatric consultants working in Ministry of Health.…”

“…Recent studies have yielded significant association between IDA and poor cognition, school achievement and behavioral problems (Carter et al, 2010;Lozoff et al, 2008;Sherriff, 2001;Williams et al, 1999). However, iron therapy can be accompanied by bothersome side effects that might affect compliance (Talebi et al, 2012).…”

Effects of iron deficiency in infancy on patterns of motor development over time

“…Eight of them found IDA infants to have lower motor scores (Akman et al, 2004;Hasanbegovic & Sabanovic, 2004;Hokama et al, 2005;Idjradinata & Pollitt, 1993;Lozoff et al, 1982Lozoff et al, ,1987Shafir Liberzon et al, 2005;Walter et al, 1989). In addition, in a British population study, low hemoglobin (Hb) concentration (≤95 g/L) in 8-month-old infants was associated with poorer motor development at 18 months (Sherriff, Emond, Bell, Golding, & Alspac, 2001). Similarly, IDA infants at risk for stunting showed poorer motor development.…”