IRON DEFICIENCY PREVALENCE AND RISK FACTORS IN CHILDREN YOUNGER THAN 6 YEARS-OLD IN FRANCE: A POPULATION-BASED STUDY
(Abstract release date: 05/19/16)
EHA Library. de Montalembert M. 06/09/16; 133017; E1468
Assoc. Prof. Mariane de Montalembert
Contributions
Contributions
Abstract
Abstract: E1468
Type: Eposter Presentation
Background
Iron deficiency (ID) is considered as the most frequent micronutrient deficiency in the world including in well-resourced countries. Iron depletion, the first stage of ID, corresponds to a reduction of body iron stores and is usually diagnosed by serum ferritin (SF) measurement. ID in early years is associated with impaired neurodevelopment both at the short and long terms. Several strategies have been proposed to prevent and/or to screen ID in children. The effectiveness of these strategies can be evaluated by the prevalence of ID. Estimated prevalences of ID in Europe are highly variable, probably because population-based studies are lacking.
Aims
Our objectives were to estimate ID prevalence and to assess ID risk factors among French children younger than 6 years-old in a population-based study.
Methods
We conducted a secondary analysis on the biobank constituted during the national survey “SaturnInf”, carried out by the InVS-French Institute for Public Health Surveillance [Etchevers, 2014]. The Saturninf study recruited 3831 French children younger than 6 years-old between 2008 and 2009 according to a two stages probability sample design. For the present ancillary study, we measured SF (electro-chemiluminescence immunoassay) and CRP (immunoturbidimetric assay) on the sera kept frozen at -80°C for children with the following criteria: parents’ written consent, sera aliquot in sufficient quantity, lack of inflammatory syndrome (CRP<10 mg/l), and available socio-demographic data. ID was defined by a SF level <10 or <12 µg/l. Uni- and multivariate analyses were performed to identify ID risk factors and correlations with SF.
Results
The 657 included children (17% of the children included in the Saturninf study) had an average age of 3.1 years (SD 1.6), 58% were boys, 12% had a mother born outside France, and 22% a family with a healthcare coverage type linked to poverty (“CMU”). SF median was 45 µg/l (IQR: 29-75). ID prevalence was 3% (95%CI: 2-5) and 4% (95%CI: 3-6) for a SF threshold of 10 and 12 µg/l, respectively. At a 10 µg/l threshold, ID prevalence was higher (p<0.05) when the mother was born outside France (8%) and when the healthcare expenses were covered by CMU (7%). Significantly (p<0.05) lower SF levels were observed among males (median 42 µg/l vs 52), when the mother was born outside France (34 vs 46), was unemployed (38 vs 46) or had a low educational level (38 vs 47), when the father had a low educational level (38 vs 48) and when the healthcare expenses of the family were covered by CMU (39 vs 47), but not (p>0.4) among youngest children (47 before 2 years-old, 41 between 2 and 3, 46 after 3 years-old) nor when the father was unemployed (39 vs 47). After adjustment, a lower SF level was significantly (p<0.01) associated with a male gender and a lower mother’s educational level.
Conclusion
In this first population-based study in France, ID prevalence was much lower (3 to 4% depending on SF threshold) than prevalences retrieved in other French and European studies performed in precarious populations but close to the lower values observed in other population-based studies in Europe. Male gender and low mother’s educational level were independent risk factors for ID, as in other studies. Further studies are needed to explore the relation between this low ID prevalence and the national French preventive strategy of ID in children that is mainly based on the recommendation of a universal use of fortified cow's milk formula between 1 and 3 years of age.
Session topic: E-poster
Keyword(s): Children, Iron deficiency, Prevalence, Risk factor
Type: Eposter Presentation
Background
Iron deficiency (ID) is considered as the most frequent micronutrient deficiency in the world including in well-resourced countries. Iron depletion, the first stage of ID, corresponds to a reduction of body iron stores and is usually diagnosed by serum ferritin (SF) measurement. ID in early years is associated with impaired neurodevelopment both at the short and long terms. Several strategies have been proposed to prevent and/or to screen ID in children. The effectiveness of these strategies can be evaluated by the prevalence of ID. Estimated prevalences of ID in Europe are highly variable, probably because population-based studies are lacking.
Aims
Our objectives were to estimate ID prevalence and to assess ID risk factors among French children younger than 6 years-old in a population-based study.
Methods
We conducted a secondary analysis on the biobank constituted during the national survey “SaturnInf”, carried out by the InVS-French Institute for Public Health Surveillance [Etchevers, 2014]. The Saturninf study recruited 3831 French children younger than 6 years-old between 2008 and 2009 according to a two stages probability sample design. For the present ancillary study, we measured SF (electro-chemiluminescence immunoassay) and CRP (immunoturbidimetric assay) on the sera kept frozen at -80°C for children with the following criteria: parents’ written consent, sera aliquot in sufficient quantity, lack of inflammatory syndrome (CRP<10 mg/l), and available socio-demographic data. ID was defined by a SF level <10 or <12 µg/l. Uni- and multivariate analyses were performed to identify ID risk factors and correlations with SF.
Results
The 657 included children (17% of the children included in the Saturninf study) had an average age of 3.1 years (SD 1.6), 58% were boys, 12% had a mother born outside France, and 22% a family with a healthcare coverage type linked to poverty (“CMU”). SF median was 45 µg/l (IQR: 29-75). ID prevalence was 3% (95%CI: 2-5) and 4% (95%CI: 3-6) for a SF threshold of 10 and 12 µg/l, respectively. At a 10 µg/l threshold, ID prevalence was higher (p<0.05) when the mother was born outside France (8%) and when the healthcare expenses were covered by CMU (7%). Significantly (p<0.05) lower SF levels were observed among males (median 42 µg/l vs 52), when the mother was born outside France (34 vs 46), was unemployed (38 vs 46) or had a low educational level (38 vs 47), when the father had a low educational level (38 vs 48) and when the healthcare expenses of the family were covered by CMU (39 vs 47), but not (p>0.4) among youngest children (47 before 2 years-old, 41 between 2 and 3, 46 after 3 years-old) nor when the father was unemployed (39 vs 47). After adjustment, a lower SF level was significantly (p<0.01) associated with a male gender and a lower mother’s educational level.
Conclusion
In this first population-based study in France, ID prevalence was much lower (3 to 4% depending on SF threshold) than prevalences retrieved in other French and European studies performed in precarious populations but close to the lower values observed in other population-based studies in Europe. Male gender and low mother’s educational level were independent risk factors for ID, as in other studies. Further studies are needed to explore the relation between this low ID prevalence and the national French preventive strategy of ID in children that is mainly based on the recommendation of a universal use of fortified cow's milk formula between 1 and 3 years of age.
Session topic: E-poster
Keyword(s): Children, Iron deficiency, Prevalence, Risk factor
Abstract: E1468
Type: Eposter Presentation
Background
Iron deficiency (ID) is considered as the most frequent micronutrient deficiency in the world including in well-resourced countries. Iron depletion, the first stage of ID, corresponds to a reduction of body iron stores and is usually diagnosed by serum ferritin (SF) measurement. ID in early years is associated with impaired neurodevelopment both at the short and long terms. Several strategies have been proposed to prevent and/or to screen ID in children. The effectiveness of these strategies can be evaluated by the prevalence of ID. Estimated prevalences of ID in Europe are highly variable, probably because population-based studies are lacking.
Aims
Our objectives were to estimate ID prevalence and to assess ID risk factors among French children younger than 6 years-old in a population-based study.
Methods
We conducted a secondary analysis on the biobank constituted during the national survey “SaturnInf”, carried out by the InVS-French Institute for Public Health Surveillance [Etchevers, 2014]. The Saturninf study recruited 3831 French children younger than 6 years-old between 2008 and 2009 according to a two stages probability sample design. For the present ancillary study, we measured SF (electro-chemiluminescence immunoassay) and CRP (immunoturbidimetric assay) on the sera kept frozen at -80°C for children with the following criteria: parents’ written consent, sera aliquot in sufficient quantity, lack of inflammatory syndrome (CRP<10 mg/l), and available socio-demographic data. ID was defined by a SF level <10 or <12 µg/l. Uni- and multivariate analyses were performed to identify ID risk factors and correlations with SF.
Results
The 657 included children (17% of the children included in the Saturninf study) had an average age of 3.1 years (SD 1.6), 58% were boys, 12% had a mother born outside France, and 22% a family with a healthcare coverage type linked to poverty (“CMU”). SF median was 45 µg/l (IQR: 29-75). ID prevalence was 3% (95%CI: 2-5) and 4% (95%CI: 3-6) for a SF threshold of 10 and 12 µg/l, respectively. At a 10 µg/l threshold, ID prevalence was higher (p<0.05) when the mother was born outside France (8%) and when the healthcare expenses were covered by CMU (7%). Significantly (p<0.05) lower SF levels were observed among males (median 42 µg/l vs 52), when the mother was born outside France (34 vs 46), was unemployed (38 vs 46) or had a low educational level (38 vs 47), when the father had a low educational level (38 vs 48) and when the healthcare expenses of the family were covered by CMU (39 vs 47), but not (p>0.4) among youngest children (47 before 2 years-old, 41 between 2 and 3, 46 after 3 years-old) nor when the father was unemployed (39 vs 47). After adjustment, a lower SF level was significantly (p<0.01) associated with a male gender and a lower mother’s educational level.
Conclusion
In this first population-based study in France, ID prevalence was much lower (3 to 4% depending on SF threshold) than prevalences retrieved in other French and European studies performed in precarious populations but close to the lower values observed in other population-based studies in Europe. Male gender and low mother’s educational level were independent risk factors for ID, as in other studies. Further studies are needed to explore the relation between this low ID prevalence and the national French preventive strategy of ID in children that is mainly based on the recommendation of a universal use of fortified cow's milk formula between 1 and 3 years of age.
Session topic: E-poster
Keyword(s): Children, Iron deficiency, Prevalence, Risk factor
Type: Eposter Presentation
Background
Iron deficiency (ID) is considered as the most frequent micronutrient deficiency in the world including in well-resourced countries. Iron depletion, the first stage of ID, corresponds to a reduction of body iron stores and is usually diagnosed by serum ferritin (SF) measurement. ID in early years is associated with impaired neurodevelopment both at the short and long terms. Several strategies have been proposed to prevent and/or to screen ID in children. The effectiveness of these strategies can be evaluated by the prevalence of ID. Estimated prevalences of ID in Europe are highly variable, probably because population-based studies are lacking.
Aims
Our objectives were to estimate ID prevalence and to assess ID risk factors among French children younger than 6 years-old in a population-based study.
Methods
We conducted a secondary analysis on the biobank constituted during the national survey “SaturnInf”, carried out by the InVS-French Institute for Public Health Surveillance [Etchevers, 2014]. The Saturninf study recruited 3831 French children younger than 6 years-old between 2008 and 2009 according to a two stages probability sample design. For the present ancillary study, we measured SF (electro-chemiluminescence immunoassay) and CRP (immunoturbidimetric assay) on the sera kept frozen at -80°C for children with the following criteria: parents’ written consent, sera aliquot in sufficient quantity, lack of inflammatory syndrome (CRP<10 mg/l), and available socio-demographic data. ID was defined by a SF level <10 or <12 µg/l. Uni- and multivariate analyses were performed to identify ID risk factors and correlations with SF.
Results
The 657 included children (17% of the children included in the Saturninf study) had an average age of 3.1 years (SD 1.6), 58% were boys, 12% had a mother born outside France, and 22% a family with a healthcare coverage type linked to poverty (“CMU”). SF median was 45 µg/l (IQR: 29-75). ID prevalence was 3% (95%CI: 2-5) and 4% (95%CI: 3-6) for a SF threshold of 10 and 12 µg/l, respectively. At a 10 µg/l threshold, ID prevalence was higher (p<0.05) when the mother was born outside France (8%) and when the healthcare expenses were covered by CMU (7%). Significantly (p<0.05) lower SF levels were observed among males (median 42 µg/l vs 52), when the mother was born outside France (34 vs 46), was unemployed (38 vs 46) or had a low educational level (38 vs 47), when the father had a low educational level (38 vs 48) and when the healthcare expenses of the family were covered by CMU (39 vs 47), but not (p>0.4) among youngest children (47 before 2 years-old, 41 between 2 and 3, 46 after 3 years-old) nor when the father was unemployed (39 vs 47). After adjustment, a lower SF level was significantly (p<0.01) associated with a male gender and a lower mother’s educational level.
Conclusion
In this first population-based study in France, ID prevalence was much lower (3 to 4% depending on SF threshold) than prevalences retrieved in other French and European studies performed in precarious populations but close to the lower values observed in other population-based studies in Europe. Male gender and low mother’s educational level were independent risk factors for ID, as in other studies. Further studies are needed to explore the relation between this low ID prevalence and the national French preventive strategy of ID in children that is mainly based on the recommendation of a universal use of fortified cow's milk formula between 1 and 3 years of age.
Session topic: E-poster
Keyword(s): Children, Iron deficiency, Prevalence, Risk factor
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