Original Article
European Journal of Clinical Nutrition (2008) 62, 1379–1387; doi:10.1038/sj.ejcn.1602862; published online 1 August 2007
A cohort study of haemoglobin and zinc protoporphyrin levels in term Zambian infants: effects of iron stores at birth, complementary food and placental malaria
Guarantor: PF van Rheenen.
Contributors: PFvR and BJB were responsible for the study idea and design. Both contributed to the analysis and interpretation of the data and to the writing of the paper. LTTdM and SE collected the data.
P F van Rheenen1, L T T de Moor2, S Eschbach2 and B J Brabin3,4,5
- 1Paediatric Gastroenterology, Department of Paediatrics, University Medical Centre, Groningen, The Netherlands
- 2University of Amsterdam, Amsterdam, The Netherlands
- 3Emma Children's Hospital – Academic Medical Centre, Amsterdam, The Netherlands
- 4Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
- 5Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Liverpool, UK
Correspondence: Dr PF van Rheenen, Department of Paediatrics, University Medical Centre Groningen, PO Box 30001, Groningen 9700 RB, The Netherlands. E-mail: p.f.vanrheenen@gmail.com
Received 21 December 2006; Revised 19 March 2007; Accepted 11 June 2007; Published online 1 August 2007.
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.
Keywords:
iron-deficiency anaemia, zinc protoporphyrin, complementary feeding, breastfeeding, placenta/parasitology, Zambia
MORE ARTICLES LIKE THIS
These links to content published by NPG are automatically generated
NEWS AND VIEWS
Nature News and Views (15 Mar 1979)
Sticky sugars attract malaria to the fetus
Nature Medicine News and Views (01 Jan 2000)
RESEARCH
Breast and complementary feeding practices in relation to morbidity and growth in Malawian infants
European Journal of Clinical Nutrition Original Article
Size and morbidity in Malawian twins
European Journal of Clinical Nutrition Original Article
