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A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants: effects of iron stores at birth, complementary food and placental malaria.
Eur J Clin Nutr. 2008 Dec; 62(12):1379-87.EJ

Abstract

OBJECTIVE

To examine zinc-protoporphyrin (ZPP) and haemoglobin levels, and to determine predictors of iron deficiency anaemia (IDA) in Zambian infants.

SUBJECTS AND METHODS

Ninety-one women and their normal birth weight (NBW) infants were followed bi-monthly during the first 6 months of life, and iron status, food intake, malaria parasitaemia and growth were monitored. At 4 months, the infants were divided into two groups, and the data were analysed according to whether or not they were exclusively breastfed.

RESULTS

Almost two-third of infants were born with low iron stores as defined by ZPP levels, and this proportion increased with age. Over 50% had developed IDA by 6 months. Exclusive breastfeeding at 4 months could be a protective factor for IDA (odds ratio (OR): 0.2; 95% confidence interval (CI): 0.0-1.1). Exclusively breastfed infants had higher haemoglobin values at 4 and 6 months (mean difference 0.6; 95% CI: 0.1-1.2 g/dl and mean difference 0.9; 95% CI: 0.2-1.7 g/dl, respectively), compared with infants with early complementary feeding. In univariate analysis, past or chronic placental malaria appeared to be a predictor of IDA at 4 and 6 months, but the significance was lost in multivariate analysis.

CONCLUSIONS

Zambian NBW infants are born with low iron stores and have a high risk to develop IDA in the first 6 months of life. Continuation of exclusive breastfeeding after 4 months is associated with a reduction of anaemia. The effect of placental malaria infection on increased risk of infant IDA could not be proven.

Authors+Show Affiliations

Paediatric Gastroenterology, Department of Paediatrics, University Medical Centre, Groningen, The Netherlands. p.f.vanrheenen@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17671442

Citation

van Rheenen, P F., et al. "A Cohort Study of Haemoglobin and Zinc Protoporphyrin Levels in Term Zambian Infants: Effects of Iron Stores at Birth, Complementary Food and Placental Malaria." European Journal of Clinical Nutrition, vol. 62, no. 12, 2008, pp. 1379-87.
van Rheenen PF, de Moor LT, Eschbach S, et al. A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants: effects of iron stores at birth, complementary food and placental malaria. Eur J Clin Nutr. 2008;62(12):1379-87.
van Rheenen, P. F., de Moor, L. T., Eschbach, S., & Brabin, B. J. (2008). A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants: effects of iron stores at birth, complementary food and placental malaria. European Journal of Clinical Nutrition, 62(12), 1379-87.
van Rheenen PF, et al. A Cohort Study of Haemoglobin and Zinc Protoporphyrin Levels in Term Zambian Infants: Effects of Iron Stores at Birth, Complementary Food and Placental Malaria. Eur J Clin Nutr. 2008;62(12):1379-87. PubMed PMID: 17671442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants: effects of iron stores at birth, complementary food and placental malaria. AU - van Rheenen,P F, AU - de Moor,L T T, AU - Eschbach,S, AU - Brabin,B J, Y1 - 2007/08/01/ PY - 2007/8/3/pubmed PY - 2009/2/24/medline PY - 2007/8/3/entrez SP - 1379 EP - 87 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 62 IS - 12 N2 - OBJECTIVE: To examine zinc-protoporphyrin (ZPP) and haemoglobin levels, and to determine predictors of iron deficiency anaemia (IDA) in Zambian infants. SUBJECTS AND METHODS: Ninety-one women and their normal birth weight (NBW) infants were followed bi-monthly during the first 6 months of life, and iron status, food intake, malaria parasitaemia and growth were monitored. At 4 months, the infants were divided into two groups, and the data were analysed according to whether or not they were exclusively breastfed. RESULTS: Almost two-third of infants were born with low iron stores as defined by ZPP levels, and this proportion increased with age. Over 50% had developed IDA by 6 months. Exclusive breastfeeding at 4 months could be a protective factor for IDA (odds ratio (OR): 0.2; 95% confidence interval (CI): 0.0-1.1). Exclusively breastfed infants had higher haemoglobin values at 4 and 6 months (mean difference 0.6; 95% CI: 0.1-1.2 g/dl and mean difference 0.9; 95% CI: 0.2-1.7 g/dl, respectively), compared with infants with early complementary feeding. In univariate analysis, past or chronic placental malaria appeared to be a predictor of IDA at 4 and 6 months, but the significance was lost in multivariate analysis. CONCLUSIONS: Zambian NBW infants are born with low iron stores and have a high risk to develop IDA in the first 6 months of life. Continuation of exclusive breastfeeding after 4 months is associated with a reduction of anaemia. The effect of placental malaria infection on increased risk of infant IDA could not be proven. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/17671442/A_cohort_study_of_haemoglobin_and_zinc_protoporphyrin_levels_in_term_Zambian_infants:_effects_of_iron_stores_at_birth_complementary_food_and_placental_malaria_ L2 - https://doi.org/10.1038/sj.ejcn.1602862 DB - PRIME DP - Unbound Medicine ER -