Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials
ABSTRACT Objective: To evaluate the effect of iron supplementation on haemoglobin (Hb) in children through a systematic review of randomised controlled trials. Materials and Methods: Electronic databases, personal files, hand search of reviews, bibliographies of books, and s and proceedings of inter...
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| Veröffentlicht in: | Journal of pediatric gastroenterology and nutrition 2007-04, Vol.44 (4), p.468-486 |
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| container_title | Journal of pediatric gastroenterology and nutrition |
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| creator | Gera, Tarun Sachdev, HPS Nestel, Penelope Sachdev, Sudeep Singh |
| description | ABSTRACT
Objective:
To evaluate the effect of iron supplementation on haemoglobin (Hb) in children through a systematic review of randomised controlled trials.
Materials and Methods:
Electronic databases, personal files, hand search of reviews, bibliographies of books, and s and proceedings of international conferences were reviewed. Randomised controlled trials evaluating change in Hb levels with interventions that included oral or parenteral iron supplementation or iron‐fortified formula milk or cereals were analysed.
Results:
A total of 55 trials (56 cohorts) provided relevant information. Publication bias was evident (P < 0.001). The pooled estimate (random‐effects model) for change in Hb with iron supplementation (weighted mean difference) was 0.74 g/dL (95% CI, 0.61–0.87; P < 0.001; P < 0.001 for heterogeneity). Lower baseline Hb level, oral medicinal iron supplementation, and malarial nonhyperendemic region were significant predictors of greater Hb response and heterogeneity. Projections suggested that, on average, between 37.9% and 62.3% of baseline anaemia (Hb |
| doi_str_mv | 10.1097/01.mpg.0000243440.85452.38 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70355834</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70355834</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5043-615a99d3e7325e4466df98cb7650411707395282b1c6dbe9bd38c783c26c587e3</originalsourceid><addsrcrecordid>eNqVkdtu1DAQhiMEokvhFVCEBHdZ7PiY3kHUoypAbbm2HGfSDThxsBNW-_ZMuyvtNT5obPn7Z0a_s-wDJWtKKvWZ0PUwPa4JjpIzzslaCy7KNdMvshUVTBZcE_oyW5FSqaKkVJ5kb1L6hbzigrzOTqjiFKdcZct514Gb89Dl1zGM-f0yTR4GGGc793jHdWVhCI8-NP2Y30Gawpggx3O96X0bYTzL73dphgEFDoG_PWyf0t3ZsQ1Dn6DN6zDOMXiPx4fYW5_eZq86DPDuEE-znxfnD_VVcfv98rr-cls4QTgrJBW2qloGipUCOJey7SrtGiXxmVJFFKtEqcuGOtk2UDUt005p5krphFbATrNP-7xTDH8WSLPBhhx4b0cISzKKMCE04wie7UEXQ0oROjPFfrBxZygxT6YbQg2abo6mm2fTDdMofn-osjQDtEfpwWUEPh4Am5z1XbSj69OR05IrRghyfM9tg58hpt9-2UI0G7B-3jyXFlTJosR_JBxvBW7KUFYfZL2H3X90bm5-fGNfLwgXlLJ_UNOuow</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70355834</pqid></control><display><type>article</type><title>Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Journals@Ovid Complete</source><creator>Gera, Tarun ; Sachdev, HPS ; Nestel, Penelope ; Sachdev, Sudeep Singh</creator><creatorcontrib>Gera, Tarun ; Sachdev, HPS ; Nestel, Penelope ; Sachdev, Sudeep Singh</creatorcontrib><description>ABSTRACT
Objective:
To evaluate the effect of iron supplementation on haemoglobin (Hb) in children through a systematic review of randomised controlled trials.
Materials and Methods:
Electronic databases, personal files, hand search of reviews, bibliographies of books, and s and proceedings of international conferences were reviewed. Randomised controlled trials evaluating change in Hb levels with interventions that included oral or parenteral iron supplementation or iron‐fortified formula milk or cereals were analysed.
Results:
A total of 55 trials (56 cohorts) provided relevant information. Publication bias was evident (P < 0.001). The pooled estimate (random‐effects model) for change in Hb with iron supplementation (weighted mean difference) was 0.74 g/dL (95% CI, 0.61–0.87; P < 0.001; P < 0.001 for heterogeneity). Lower baseline Hb level, oral medicinal iron supplementation, and malarial nonhyperendemic region were significant predictors of greater Hb response and heterogeneity. Projections suggested that, on average, between 37.9% and 62.3% of baseline anaemia (Hb <11 g/dL) was responsive to iron supplementation among children under 6 years of age; the corresponding range for malarial hyperendemic regions was 5.8% to 31.8%.
Conclusions:
This systematic review indicates that iron supplementation increases Hb levels in children significantly but modestly. The increase is greater in subjects who are anaemic at the start of the trial and lower in malarial hyperendemic areas and in those consuming iron‐fortified food. The projected reductions in prevalence of anaemia with iron supplementation alone highlight the need for additional area‐specific interventions, particularly in malaria‐prone regions.</description><identifier>ISSN: 0277-2116</identifier><identifier>EISSN: 1536-4801</identifier><identifier>DOI: 10.1097/01.mpg.0000243440.85452.38</identifier><identifier>PMID: 17414146</identifier><identifier>CODEN: JPGND6</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Administration, Oral ; Adolescent ; Anaemia ; Anemia - drug therapy ; Anemias. Hemoglobinopathies ; Biological and medical sciences ; Child ; Child, Preschool ; Dietary Supplements ; Diseases of red blood cells ; Diseases of the digestive system ; Edible Grain ; Food, Fortified ; Haemoglobin ; Hematologic and hematopoietic diseases ; Hemoglobins - analysis ; Human protozoal diseases ; Humans ; Infant ; Infant Formula ; Infectious diseases ; Iron Compounds - administration & dosage ; Iron supplementation ; Malaria ; Medical sciences ; Meta‐analysis ; Parasitic diseases ; Protozoal diseases ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Randomized Controlled Trials as Topic</subject><ispartof>Journal of pediatric gastroenterology and nutrition, 2007-04, Vol.44 (4), p.468-486</ispartof><rights>2007 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition</rights><rights>2007 Lippincott Williams & Wilkins, Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5043-615a99d3e7325e4466df98cb7650411707395282b1c6dbe9bd38c783c26c587e3</citedby><cites>FETCH-LOGICAL-c5043-615a99d3e7325e4466df98cb7650411707395282b1c6dbe9bd38c783c26c587e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F01.mpg.0000243440.85452.38$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F01.mpg.0000243440.85452.38$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18647300$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17414146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gera, Tarun</creatorcontrib><creatorcontrib>Sachdev, HPS</creatorcontrib><creatorcontrib>Nestel, Penelope</creatorcontrib><creatorcontrib>Sachdev, Sudeep Singh</creatorcontrib><title>Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials</title><title>Journal of pediatric gastroenterology and nutrition</title><addtitle>J Pediatr Gastroenterol Nutr</addtitle><description>ABSTRACT
Objective:
To evaluate the effect of iron supplementation on haemoglobin (Hb) in children through a systematic review of randomised controlled trials.
Materials and Methods:
Electronic databases, personal files, hand search of reviews, bibliographies of books, and s and proceedings of international conferences were reviewed. Randomised controlled trials evaluating change in Hb levels with interventions that included oral or parenteral iron supplementation or iron‐fortified formula milk or cereals were analysed.
Results:
A total of 55 trials (56 cohorts) provided relevant information. Publication bias was evident (P < 0.001). The pooled estimate (random‐effects model) for change in Hb with iron supplementation (weighted mean difference) was 0.74 g/dL (95% CI, 0.61–0.87; P < 0.001; P < 0.001 for heterogeneity). Lower baseline Hb level, oral medicinal iron supplementation, and malarial nonhyperendemic region were significant predictors of greater Hb response and heterogeneity. Projections suggested that, on average, between 37.9% and 62.3% of baseline anaemia (Hb <11 g/dL) was responsive to iron supplementation among children under 6 years of age; the corresponding range for malarial hyperendemic regions was 5.8% to 31.8%.
Conclusions:
This systematic review indicates that iron supplementation increases Hb levels in children significantly but modestly. The increase is greater in subjects who are anaemic at the start of the trial and lower in malarial hyperendemic areas and in those consuming iron‐fortified food. The projected reductions in prevalence of anaemia with iron supplementation alone highlight the need for additional area‐specific interventions, particularly in malaria‐prone regions.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Anaemia</subject><subject>Anemia - drug therapy</subject><subject>Anemias. Hemoglobinopathies</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Dietary Supplements</subject><subject>Diseases of red blood cells</subject><subject>Diseases of the digestive system</subject><subject>Edible Grain</subject><subject>Food, Fortified</subject><subject>Haemoglobin</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hemoglobins - analysis</subject><subject>Human protozoal diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Formula</subject><subject>Infectious diseases</subject><subject>Iron Compounds - administration & dosage</subject><subject>Iron supplementation</subject><subject>Malaria</subject><subject>Medical sciences</subject><subject>Meta‐analysis</subject><subject>Parasitic diseases</subject><subject>Protozoal diseases</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Randomized Controlled Trials as Topic</subject><issn>0277-2116</issn><issn>1536-4801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkdtu1DAQhiMEokvhFVCEBHdZ7PiY3kHUoypAbbm2HGfSDThxsBNW-_ZMuyvtNT5obPn7Z0a_s-wDJWtKKvWZ0PUwPa4JjpIzzslaCy7KNdMvshUVTBZcE_oyW5FSqaKkVJ5kb1L6hbzigrzOTqjiFKdcZct514Gb89Dl1zGM-f0yTR4GGGc793jHdWVhCI8-NP2Y30Gawpggx3O96X0bYTzL73dphgEFDoG_PWyf0t3ZsQ1Dn6DN6zDOMXiPx4fYW5_eZq86DPDuEE-znxfnD_VVcfv98rr-cls4QTgrJBW2qloGipUCOJey7SrtGiXxmVJFFKtEqcuGOtk2UDUt005p5krphFbATrNP-7xTDH8WSLPBhhx4b0cISzKKMCE04wie7UEXQ0oROjPFfrBxZygxT6YbQg2abo6mm2fTDdMofn-osjQDtEfpwWUEPh4Am5z1XbSj69OR05IrRghyfM9tg58hpt9-2UI0G7B-3jyXFlTJosR_JBxvBW7KUFYfZL2H3X90bm5-fGNfLwgXlLJ_UNOuow</recordid><startdate>200704</startdate><enddate>200704</enddate><creator>Gera, Tarun</creator><creator>Sachdev, HPS</creator><creator>Nestel, Penelope</creator><creator>Sachdev, Sudeep Singh</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200704</creationdate><title>Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials</title><author>Gera, Tarun ; Sachdev, HPS ; Nestel, Penelope ; Sachdev, Sudeep Singh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5043-615a99d3e7325e4466df98cb7650411707395282b1c6dbe9bd38c783c26c587e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Anaemia</topic><topic>Anemia - drug therapy</topic><topic>Anemias. Hemoglobinopathies</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Dietary Supplements</topic><topic>Diseases of red blood cells</topic><topic>Diseases of the digestive system</topic><topic>Edible Grain</topic><topic>Food, Fortified</topic><topic>Haemoglobin</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hemoglobins - analysis</topic><topic>Human protozoal diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Formula</topic><topic>Infectious diseases</topic><topic>Iron Compounds - administration & dosage</topic><topic>Iron supplementation</topic><topic>Malaria</topic><topic>Medical sciences</topic><topic>Meta‐analysis</topic><topic>Parasitic diseases</topic><topic>Protozoal diseases</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Randomized Controlled Trials as Topic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gera, Tarun</creatorcontrib><creatorcontrib>Sachdev, HPS</creatorcontrib><creatorcontrib>Nestel, Penelope</creatorcontrib><creatorcontrib>Sachdev, Sudeep Singh</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gera, Tarun</au><au>Sachdev, HPS</au><au>Nestel, Penelope</au><au>Sachdev, Sudeep Singh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials</atitle><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle><addtitle>J Pediatr Gastroenterol Nutr</addtitle><date>2007-04</date><risdate>2007</risdate><volume>44</volume><issue>4</issue><spage>468</spage><epage>486</epage><pages>468-486</pages><issn>0277-2116</issn><eissn>1536-4801</eissn><coden>JPGND6</coden><abstract>ABSTRACT
Objective:
To evaluate the effect of iron supplementation on haemoglobin (Hb) in children through a systematic review of randomised controlled trials.
Materials and Methods:
Electronic databases, personal files, hand search of reviews, bibliographies of books, and s and proceedings of international conferences were reviewed. Randomised controlled trials evaluating change in Hb levels with interventions that included oral or parenteral iron supplementation or iron‐fortified formula milk or cereals were analysed.
Results:
A total of 55 trials (56 cohorts) provided relevant information. Publication bias was evident (P < 0.001). The pooled estimate (random‐effects model) for change in Hb with iron supplementation (weighted mean difference) was 0.74 g/dL (95% CI, 0.61–0.87; P < 0.001; P < 0.001 for heterogeneity). Lower baseline Hb level, oral medicinal iron supplementation, and malarial nonhyperendemic region were significant predictors of greater Hb response and heterogeneity. Projections suggested that, on average, between 37.9% and 62.3% of baseline anaemia (Hb <11 g/dL) was responsive to iron supplementation among children under 6 years of age; the corresponding range for malarial hyperendemic regions was 5.8% to 31.8%.
Conclusions:
This systematic review indicates that iron supplementation increases Hb levels in children significantly but modestly. The increase is greater in subjects who are anaemic at the start of the trial and lower in malarial hyperendemic areas and in those consuming iron‐fortified food. The projected reductions in prevalence of anaemia with iron supplementation alone highlight the need for additional area‐specific interventions, particularly in malaria‐prone regions.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>17414146</pmid><doi>10.1097/01.mpg.0000243440.85452.38</doi><tpages>19</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0277-2116 |
| ispartof | Journal of pediatric gastroenterology and nutrition, 2007-04, Vol.44 (4), p.468-486 |
| issn | 0277-2116 1536-4801 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Journals@Ovid Complete |
| subjects | Administration, Oral Adolescent Anaemia Anemia - drug therapy Anemias. Hemoglobinopathies Biological and medical sciences Child Child, Preschool Dietary Supplements Diseases of red blood cells Diseases of the digestive system Edible Grain Food, Fortified Haemoglobin Hematologic and hematopoietic diseases Hemoglobins - analysis Human protozoal diseases Humans Infant Infant Formula Infectious diseases Iron Compounds - administration & dosage Iron supplementation Malaria Medical sciences Meta‐analysis Parasitic diseases Protozoal diseases Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Randomized Controlled Trials as Topic |
| title | Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials |
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