TY - JOUR
T1 - Unexplained decline in the prevalence of anemia among US children and women between 1988-1994 and 1999-2002
AU - Cusick, Sarah E.
AU - Mei, Zuguo
AU - Freedman, David S.
AU - Looker, Anne C.
AU - Ogden, Cynthia L.
AU - Gunter, Elaine
AU - Cogswell, Mary E.
PY - 2008/12/1
Y1 - 2008/12/1
N2 - Background: The current anemia burden among US preschool children and women of childbearing age has not been documented. Objective: We used data from National Health and Nutrition Examination Surveys 1988-1994 and 1999-2002 to examine recent anemia changes. Design: We calculated the prevalence of anemia (hemoglobin < 11.0 g/dL at <24 mo, <11.1 g/dL at 24-59 mo, and <12.0 g/dL for women), iron deficiency anemia (anemia plus abnormal value ≥2: serum ferritin, transferrin saturation, and erythrocyte protoporphyrin), and high blood lead (≥10 μg/dL) with anemia among children 12-59 mo and women 20-49 y in both surveys. Among women, we also calculated the prevalence of folate deficiency (erythrocyte folate <317.2 nmol/L) with anemia and high C-reactive protein (>10 mg/L) with anemia. Multiple logistic regression was used to compare anemia prevalence between surveys, with control for race and age. Results: Anemia declined significantly in children (from 8.0% to 3.6%; OR: 0.4; 95% CI: 0.3, 0.7) and women (10.8% to 6.9%; OR: 0.6; CI: 0.4, 0.7), but the prevalence of iron deficiency anemia did not change significantly in children (1.5% compared with 1.2%; OR: 0.7; 95% CI: 0.4, 1.5) or women (4.9% compared with 4.1%; OR: 0.8; 95% CI: 0.6, 1.1). Folate deficiency with anemia declined significantly in women (from 4.1% to 0.5%; OR: 0.1; 95% CI: 0.1, 0.2), but logistic regression models and standardization indicated that none of the known possible anemia causes could account for the decline in total anemia in children or women. Conclusions: The prevalence of anemia declined significantly among US women and children between 1988-1994 and 1999-2002, but this decline was not associated with changes in iron or folate deficiency, inflammation, or high blood lead.
AB - Background: The current anemia burden among US preschool children and women of childbearing age has not been documented. Objective: We used data from National Health and Nutrition Examination Surveys 1988-1994 and 1999-2002 to examine recent anemia changes. Design: We calculated the prevalence of anemia (hemoglobin < 11.0 g/dL at <24 mo, <11.1 g/dL at 24-59 mo, and <12.0 g/dL for women), iron deficiency anemia (anemia plus abnormal value ≥2: serum ferritin, transferrin saturation, and erythrocyte protoporphyrin), and high blood lead (≥10 μg/dL) with anemia among children 12-59 mo and women 20-49 y in both surveys. Among women, we also calculated the prevalence of folate deficiency (erythrocyte folate <317.2 nmol/L) with anemia and high C-reactive protein (>10 mg/L) with anemia. Multiple logistic regression was used to compare anemia prevalence between surveys, with control for race and age. Results: Anemia declined significantly in children (from 8.0% to 3.6%; OR: 0.4; 95% CI: 0.3, 0.7) and women (10.8% to 6.9%; OR: 0.6; CI: 0.4, 0.7), but the prevalence of iron deficiency anemia did not change significantly in children (1.5% compared with 1.2%; OR: 0.7; 95% CI: 0.4, 1.5) or women (4.9% compared with 4.1%; OR: 0.8; 95% CI: 0.6, 1.1). Folate deficiency with anemia declined significantly in women (from 4.1% to 0.5%; OR: 0.1; 95% CI: 0.1, 0.2), but logistic regression models and standardization indicated that none of the known possible anemia causes could account for the decline in total anemia in children or women. Conclusions: The prevalence of anemia declined significantly among US women and children between 1988-1994 and 1999-2002, but this decline was not associated with changes in iron or folate deficiency, inflammation, or high blood lead.
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U2 - 10.3945/ajcn.2008.25926
DO - 10.3945/ajcn.2008.25926
M3 - Article
C2 - 19064522
AN - SCOPUS:57449110583
SN - 0002-9165
VL - 88
SP - 1611
EP - 1617
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 6
ER -