Iron-deficiency anemia and associated factors among preschool children in Diamantina, Minas Gerais, Brazil

ABSTRACT Objective: Study the prevalence of iron depletion and iron-deficiency anemia and their associated factors in preschool children. Methods: Cross-sectional study with five-year old preschool children from a birth cohort of the city of Diamantina, Minas Gerais state, Brazil. Socioeconomic, demographic, and dietary characteristics were obtained through a questionnaire administered to each child mother or guardian. Iron depletion (normal hemoglobin and low serum ferritin levels) and iron-deficiency anemia (hemoglobin level than 11g/dL) were detected after collecting 5mL of venous blood of preschool children. Poisson regression was used to identify the factors associated with iron depletion and iron-deficiency anemia. Results: A total of 228 preschool were evaluated, corresponding to 97.4% of the children from a cohort study followed-up up to the end of their first year of life. Iron depletion and iron-deficiency anemia were detected, respectively, in 15.9% and 18.9% of the preschool children evaluated. Iron depletion was not associated with any variable studied, while low maternal education level was associated with iron-deficiency anemia (PR=1.83; P=0.03). Conclusion: Iron-deficiency anemia is considered as a mild public health problem among 5-year old children in the city of Diamantina, Minas Gerais. Higher maternal education level was a protective factor against this deficiency, and therefore it is as an important marker for the occurrence of iron-deficiency anemia in the population studied.

摘要
目的：研究巴西米纳斯吉拉斯州迪亚曼蒂纳市某出生队列（birth cohort）中5岁学龄前儿童的铁缺乏与缺铁性贫血的患病率及其相关影响因素。
方法：本研究为横断面研究，研究对象为上述出生队列的5岁学龄前儿童。通过向儿童母亲或监护人发放问卷，收集研究对象的社会经济状况、人口统计学特征及膳食摄入情况。采集学龄前儿童5mL静脉血样，检测铁缺乏（血红蛋白水平正常、血清铁蛋白（serum ferritin）水平降低）与缺铁性贫血（血红蛋白水平低于11g/dL）的发生情况。采用泊松回归（Poisson regression）分析识别与铁缺乏、缺铁性贫血相关的影响因素。
结果：本研究共评估228名学龄前儿童，对应该队列随访至1周岁时的儿童总数的97.4%。在本次评估的学龄前儿童中，铁缺乏与缺铁性贫血的检出率分别为15.9%与18.9%。铁缺乏未与任何研究变量存在统计学关联，而母亲低学历水平与缺铁性贫血存在显著关联（PR=1.83；P=0.03）。
结论：在迪亚曼蒂纳市的5岁儿童群体中，缺铁性贫血属于轻度公共卫生问题。较高的母亲学历水平是该营养缺乏症的保护因素，因此可作为本次研究人群中缺铁性贫血发生的重要预测指标。