Should infants be screened for anaemia? A prospective study investigating the relation between haemoglobin at 8, 12, and 18 months and development at 18 months
Should infants be screened for anaemia? A prospective study investigating the relation between haemoglobin at 8, 12, and 18 months and development at 18 months
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DOI：
10.1136/adc.84.6.480
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发表时间：
2001-06-01
影响因子：
5.2
通讯作者：
Golding, J
中科院分区：
文献类型：
--
作者：
Sherriff, A;Emond, A;Golding, J
目的 - 调查 8 至 18 个月纵向随访的儿童血红蛋白与 18 个月发育结果之间的关系。方法 - 雅芳妊娠和儿童纵向研究 (ALSPAC) 是对 1991-92 年出生的地理界定儿童群体进行的纵向调查。在随机选择的子样本中，在 8、12 和 18 个月时对血液样本进行 Db 检测；使用格里菲斯智力发展量表对 1141 名儿童进行了第 s 个月的发育评估。结果 - 8 个月时的 Hb 与 18 个月时运动量表的表现之间存在很强的二次相关性。随着 Hb 增加至 95 g/l，平均分数也随之增加； Hb 水平超过 95 gm 时，几乎没有额外的发育益处。 8 个月时 Hb < 95 g/l 的婴儿在运动分量表上的得分平均比 Hb 大于或等于 95 g/l 的婴儿低 6 分； 8 个月时 Hb < 90 g/l 的婴儿在运动分量表上的得分比 Hb 大于或等于 90 g/l 的儿童低 12 分。结论 - 8 个月大儿童的低 Hb 浓度（小于或等于 95 g/l）与 18 个月时运动发育受损有关。该截止点对应于 8 个月时 Hb 的第 5 个百分位。结果表明，如果低 Hb 对发育结果有不利影响，则在 8 个月或更早时进行筛查可能比该年龄之后更有效。随着儿童年龄的增长，我们建议研究婴儿贫血与更准确和详细的长期结果之间的重要性。
Aims - To investigate the relation between haemoglobin in children followed longitudinally from 8 to 18 months, and developmental outcome at 18 months.Methods - The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) is a longitudinal survey of a geographically defined population of children born in 1991-92. In a randomly selected subsample, blood samples were assayed for Db at 8, 12, and 18 months; a developmental assessment was carried out at is months on 1141 children using the Griffiths Scales of Mental Development.Results - There was a strong quadratic association between Hb at 8 months and performance on the locomotor subscale at 18 months. Average scores increased with increasing Hb up to 95 g/l; there was little additional developmental benefit in Hb levels beyond 95 gm. Infants with Hb < 95 g/l at 8 months of age scored on average 6 points lower on the locomotor subscale than infants with Hb greater than or equal to 95 g/l; infants with Hb < 90 g/l at 8 months scored 12 points lower on the locomotor subscale than children with Hb greater than or equal to 90 g/l.Conclusions - Low Hb concentrations (less than or equal to 95 g/l) in 8 month old children are associated with impaired motor development at 18 months. This cut off point corresponds to the 5th centile of Hb at 8 months. The results indicate that if there is an adverse effect of low Hb on developmental outcome, screening may be more effective at 8 months or earlier, rather than after this age. We propose to examine the importance of infant anaemia in relation to more accurate and detailed long term outcomes as the children get older.