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Prevalence of anemia among James Bay Cree infants of northern Quebec.
CMAJ 2000; 162(3):323-6CMAJ

Abstract

BACKGROUND

Anemia is common among First Nation infants in Canada, often as a result of iron deficiency, which places them at risk for psychomotor impairment. Prevalence data are unavailable, and the risk factors are unknown. This study assessed the prevalence of anemia and associated risk factors among 9-month-old Cree infants in northern Quebec.

METHODS

Between January 1995 and October 1998, 6 of 9 Cree villages in the James Bay region adopted a screening protocol for anemia in 9-month-old infants. Cross-sectional data were obtained from medical charts. The data for babies of very low birth weight and those with fever or infection were excluded. Among the 386 babies whose hemoglobin concentration was known, the type of milk consumed at the time of screening was known for 354. Associations between hemoglobin concentration and mean cell volume at 9 months, and milk type and weight gain since birth were analysed.

RESULTS

The mean hemoglobin concentration of the 386 infants was 114.1 (standard deviation [SD] 10.6) g/L. The prevalence of anemia was 31.9% (95% confidence interval [CI] 27.2%-36.7%) with a hemoglobin cutoff value of 110 g/L, 17.6% 95% CI 13.9%-21.7%) with a cutoff value of 105 g/L, and 7.8% (95% CI 5.3%-10.9%) with a cutoff value of 100 g/L. Babies exclusively fed formula at 9 months had a higher mean hemoglobin concentration (118.5 [SD 9.9] g/L) than those exclusively fed breast milk (109.9 [SD 10.0] g/L), cow's milk (112.5 [SD 10.1] g/L) or more than one type of milk (112.0 [SD 10.8] g/L) (p < 0.05). Compared with formula, the odds ratio (OR) for anemia was 7.9 (95% CI 3.4-18.2) for breast milk, 5.0 (95% CI 2.0-12.7) for cow's milk and 5.2 (95% CI 1.9-14.6) for mixed milks. Infants fed formula and those fed cow's milk had significantly greater weight gains since birth, by 724 g and 624 g respectively, than breast-fed infants (p < 0.05). When milk type was controlled for, weight gain since birth was significantly associated with the presence of microcytic erythrocytes (OR comparing highest tertile of weight gain to lowest tertile 2.9, 95% CI 1.2-6.6).

INTERPRETATION

Iron-deficiency anemia is highly prevalent among James Bay Cree infants. Measures to increase iron intake are required.

Authors+Show Affiliations

School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Que.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10693587

Citation

Willows, N D., et al. "Prevalence of Anemia Among James Bay Cree Infants of Northern Quebec." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 162, no. 3, 2000, pp. 323-6.
Willows ND, Morel J, Gray-Donald K. Prevalence of anemia among James Bay Cree infants of northern Quebec. CMAJ. 2000;162(3):323-6.
Willows, N. D., Morel, J., & Gray-Donald, K. (2000). Prevalence of anemia among James Bay Cree infants of northern Quebec. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 162(3), pp. 323-6.
Willows ND, Morel J, Gray-Donald K. Prevalence of Anemia Among James Bay Cree Infants of Northern Quebec. CMAJ. 2000 Feb 8;162(3):323-6. PubMed PMID: 10693587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of anemia among James Bay Cree infants of northern Quebec. AU - Willows,N D, AU - Morel,J, AU - Gray-Donald,K, PY - 2000/2/29/pubmed PY - 2000/3/18/medline PY - 2000/2/29/entrez SP - 323 EP - 6 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 162 IS - 3 N2 - BACKGROUND: Anemia is common among First Nation infants in Canada, often as a result of iron deficiency, which places them at risk for psychomotor impairment. Prevalence data are unavailable, and the risk factors are unknown. This study assessed the prevalence of anemia and associated risk factors among 9-month-old Cree infants in northern Quebec. METHODS: Between January 1995 and October 1998, 6 of 9 Cree villages in the James Bay region adopted a screening protocol for anemia in 9-month-old infants. Cross-sectional data were obtained from medical charts. The data for babies of very low birth weight and those with fever or infection were excluded. Among the 386 babies whose hemoglobin concentration was known, the type of milk consumed at the time of screening was known for 354. Associations between hemoglobin concentration and mean cell volume at 9 months, and milk type and weight gain since birth were analysed. RESULTS: The mean hemoglobin concentration of the 386 infants was 114.1 (standard deviation [SD] 10.6) g/L. The prevalence of anemia was 31.9% (95% confidence interval [CI] 27.2%-36.7%) with a hemoglobin cutoff value of 110 g/L, 17.6% 95% CI 13.9%-21.7%) with a cutoff value of 105 g/L, and 7.8% (95% CI 5.3%-10.9%) with a cutoff value of 100 g/L. Babies exclusively fed formula at 9 months had a higher mean hemoglobin concentration (118.5 [SD 9.9] g/L) than those exclusively fed breast milk (109.9 [SD 10.0] g/L), cow's milk (112.5 [SD 10.1] g/L) or more than one type of milk (112.0 [SD 10.8] g/L) (p < 0.05). Compared with formula, the odds ratio (OR) for anemia was 7.9 (95% CI 3.4-18.2) for breast milk, 5.0 (95% CI 2.0-12.7) for cow's milk and 5.2 (95% CI 1.9-14.6) for mixed milks. Infants fed formula and those fed cow's milk had significantly greater weight gains since birth, by 724 g and 624 g respectively, than breast-fed infants (p < 0.05). When milk type was controlled for, weight gain since birth was significantly associated with the presence of microcytic erythrocytes (OR comparing highest tertile of weight gain to lowest tertile 2.9, 95% CI 1.2-6.6). INTERPRETATION: Iron-deficiency anemia is highly prevalent among James Bay Cree infants. Measures to increase iron intake are required. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/10693587/Prevalence_of_anemia_among_James_Bay_Cree_infants_of_northern_Quebec_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=long&amp;pmid=10693587 DB - PRIME DP - Unbound Medicine ER -