A Retrospective Case-Control Study of the Determinants of Iron Deficiency Anemia in Infants in an Urban Community in Shanghai China Between 2010-2015

Abstract

Background: Iron deficiency anemia (IDA) is a global public health problem. This study aimed to analyze the social determinants of IDA in infants living in Shanghai, China, between 2010-2015. Material/Methods: Data were analyzed retrospectively from the Shanghai Children's Health Check Record system in the Tangqiao Community Health Service Center for infants aged <24 months between January 1, 2010, and December 31, 2015. A study group was identified with IDA, and an age-matched and gender-matched healthy control group was identified. Results: The five-year prevalence rate of IDA was 11.49% (150/1305). Infants with IDA had significantly lower birth weights (3228.720 +/- 456.200 gm vs. 3376.870 +/- 393.719 gm; P<0.01), a higher percentage of premature births (10.67% vs. 1.33%; P<0.001), a longer exclusive breastfeeding period (10.63 +/- 4.844 months vs. 7.08 +/- 5.039 months; P<0.001), a higher rate of exclusive breastfeeding within four months after birth (P<0.001), a later start for complementary feeding (7.32 +/- 1.633 months vs. 6.93 +/- 1.794 months; P<0.05), and a higher rate of starting complementary feeding after 6 months of age (P<0.05). There were no significant differences between the two groups for maternal child-bearing age, mode of delivery, infant birth height, and birth rank. Conclusions: The introduction of an iron-fortified formula for exclusively breastfed infants at 4 months of age, starting complementary feeding promptly before 6 months of age, and improving perinatal care for pregnant women to avoid premature birth and reduce low birth weight may be effective measures to prevent IDA.