A Multi-center Study And Analysis Of Iron Deficiency Anemia In Infants And Young Children With Health Examination In Linyi Area

【Object】To understand the prevalence and current situation of iron deficiency anemia in infants aged 6-36 months in Linyi,analyze the high risk factors of iron deficiency anemia in infants of different age groups,and analysis of its relationship with recurrent respiratory tract infections,chronic constipation,chronic diarrhea,allergic diseases and other common diseases,in order to improve the family,childcare institutions to scientific feeding attention.【Methods】Infants from 6 to 36 months of age who underwent health examinations at three different levels of hospitals at the municipal,county and town levels in Linyi from September 2018 to June 2019 were selected as the research subjects.Excluding infants and young children with other diseases who have been diagnosed with other types of anemia and whose presence may have an impact on the result.A combination of questionnaire survey and laboratory testing was used.We collected blood from fingertips of all infants and young children for routine blood tests,and surveyed their parents or caregivers according to a self-made questionnaire.Collect information including the birth status,feeding status,trace element supplement status,disease status and general family status of infants and young children.Blood routine was rechecked 3 weeks after oral iron therapy for small cell hypopigmented anemia in infants.Infants and young children of IDA were divided into three groups of 6-12months（6≤month age<13）,13-24（13≤month age<25）,25-36（25≤month age≤36）months according to the size of the month,Each months of age group is divided into IDA group and non-IDA group.Using spss24.0 software package to establish database and statistical analysis of the data;using chi-square test to analyze the influencing factors of iron deficiency anemia,using two-classification multi-factor Logistic regression analysis to analyze the influencing factors of iron deficiency anemia;and using chi-square test to compare the prevalence of recurrent respiratory tract infection,long-term constipation,chronic diarrhea,allergic diseases and other common diseases in IDA and non-IDA groups of infants and young children.【Results】1.A total of 1,137 infants were included in the study,602 males（52.9%）and 535 females（47.1%）.A total of 256 infants and young children meeting IDA had a prevalence rate of22.51%,mild anemia accounted for 90.23%,moderate anemia accounted for 9.77%,and no children with severe anemia;including 144 male children The prevalence rate was 23.9%.There were 112 female children with a prevalence rate of 20.9%.There was no statistically significant difference in the prevalence of IDA among infants of different genders(c^（17）（28）2.983,P=0.13).A total of 569 infants and young children aged 6-12 months,the IDA prevalence rate was 33.21%;there were 396 cases in the 13-24 month group and the IDA prevalence rate was 14.89%;396 cases in the 25-36 month group,and the IDA prevalence rate was 4.65%;The prevalence of IDA in the 3-month age group was statistically different(c^（17）（28）85.5,P<0.01).After three weeks of iron supplementation for 256 infants,there were 251 infants with different degrees of hemoglobin increase,the effective rate of iron treatment was 98%.2.Single factor analysis of infant IDA.（1）The impact of perinatal conditions on infants and young children IDA.Anemia during maternal pregnancy is correlated with the prevalence of IDA in infantsand young children aged 6-12 months,which increases the risk of infants and young children suffering from IDA（P<0.05）.Iron supplements during pregnancy were associated with a reduced risk,which is a protective factor（P<0.05）.Preterm birth and low birth weight were associated with a statistically significant prevalence of IDA in infants aged 6-12 months（P<0.05）.These factors were not statistically associated with the prevalence of IDA in the other two groups（P>0.05）.（2）The impact of feeding on infant IDA.Exclusive breastfeeding is a risk factor for IDA between 6-12 months of age（P<0.05）,and it is no statistically relate to IDA in the other two months of age group（P>0.05）.Supplementation at inappropriate months was associated with a statistically s ignificant prevalence of IDA in infants aged 6-12 months and 13-24 months（P<0.05）,but not statistically significant with IDA prevalence at 25-36 months（P>0.05）.The p revalence of IDA in infants aged 6-12 months and 13-24 months was statistically dif ferent with or without oral iron supplementation（P<0.05）.Iron supplementation is a protective factor,but there was no statistical correlation with the prevalence of IDA i n 25-36 months（P>0.05）.Dietary imbalance increased the risk of IDA in infants of three different age groups,which was statistically significant（P<0.05）.（3）The impact of family conditions on infant IDA.Low parental education level is a risk factor for the prevalence of IDA in infants aged6-12 months and 13-24 months,with statistical significance（P<0.05）,and there was no statistically significant correlation between the rates for IDA prevalence in infants aged25-36 months（P>0.05）;the prevalence of IDA among three different groups of parents as the primary caregiver compared with others as the caregiver was a protective factor and had statistical significance（P<0.05）.Low family income increased the risk of IDA in all three age groups,which was statistically significant（P<0.05）.（4）The impact of common diseases on infant IDA.Repeated respiratory infections and chronic constipation increased the risk of IDA in infants of the three months,which was statistically significant（P<0.05）.Allergic diseases were the risk factors for IDA in infants aged 6-12 months（P<0.05）,and there was no statistical correlation with IDA in other two age groups（P>0.05）.There was no statistical correlation between chronic diarrhea and IDA prevalence in all age groups（P>0.05）.3.Multi-factor analysis of infant IDA.Multi-factor conditional logistic regression analysis results showed that,Preterm birth（OR=1.415,95%,CI:1.031-2.216）,Breastfeeding（OR=2.275,95%CI:1.014-5.108）,Addi-ng supplementary food too late（OR=1.830,95%CI:2.765-9.934）,Dietary compositio n imbalance（no meat,eggs）（OR=0.217/0.465,95%CI:（0.084-0.560）/（1.690-13.431））,Low household income（OR=0.435,95%CI:1.020-3.285）,Parents do not act as primary caregivers（OR=13.026,95%CI:0.227-0.832）,Maternal anemia during pregnan-cy（OR=22.926,95%CI:5.854-28.984）,Repeated respiratory infections（OR=22.926,95%CI=2.618-200.75）,Constipation（OR=2.548,95%CI=1.451-4.475）was the relate-d factors of IDA in the 6-12 month old group.Adding supplementary food too late（OR=5.802,95%CI:1.005-33.497）,Dietary composition imbalance（no meat,eggs）（OR=28.514/9.338,95%CI:（7.720-105.31）/（2.381-37.018））,Low household income（OR=0.013,95%CI=0.013-0.707）,Recurrent respiratory infection（OR=2.345,95%CI:2.354-44.297）,Constipation（OR=8.447,95%CI:2.554-27.932）increased the risk of IDA in the13-24 month age group.Low household income（OR=0.689,95%CI:0.494-0.961）incre-ased the risk of IDA in the 25-36 month age group.4.The relationship between infant IDA and disease.Infants with IDA had a statistically significant increase in the risk of recurrent res-piratory infections compared with infants without IDA(c^（17）=25.89,P<0.001).There was no statistical difference in the prevalence of chronic constipation,chronic diarrhea an-d allergic diseases among infants with or without IDA(c^（17）=2.51,P=0.074),(c^（17）=3.281,P=0.059),(c^（17）=0.187,P=0.367).【Conclusion】1.The prevalence of iron deficiency anemia in infants aged 6-36 months in this study was22.51%,which is lower than the prevalence in 1996（35.36%）,but it is still at a high level.2.There is no gender difference in the prevalence of iron deficiency anemia,and the high-risk age is 6-12 months.3.The risk factors of iron deficiency anemia are different in different age groups.4.Repeated respiratory tract infection and iron deficiency anemia are risk factors and influence each other,which is easy to form a vicious circle and is adverse to the growth and development of infants.