BMJ Paediatrics Open (Feb 2020)

Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study

  • Michael Peer,
  • Tara Kiran,
  • Noor Ramji,
  • Mary Beth Derocher,
  • Margarita Lam-Antoniades,
  • Peter Szatmari,
  • Gerald Lebovic,
  • Peter Jüni,
  • Colin Macarthur,
  • Christopher Allen,
  • Julia Thompson,
  • Charlie Guiang,
  • Kevin Thorpe,
  • Marty Perlmutar,
  • Douglas Campbell,
  • Andreas Laupacis,
  • Elise Mok,
  • Curtis Handford,
  • Suzanne Turner,
  • Christine Koroshegyi,
  • Catherine S. Birken,
  • Jonathon L. Maguire,
  • Ronald Cohn,
  • Eddy Lau,
  • Patricia C. Parkin,
  • Michael Salter,
  • Shannon Weir,
  • Laura N. Anderson,
  • Cornelia M. Borkhoff,
  • Charles Keown-Stoneman,
  • Christine Kowal,
  • Dalah Mason,
  • Murtala Abdurrahman,
  • Kelly Anderson,
  • Gordon Arbess,
  • Jillian Baker,
  • Tony Barozzino,
  • Sylvie Bergeron,
  • Dimple Bhagat,
  • Gary Bloch,
  • Joey Bonifacio,
  • Ashna Bowry,
  • Caroline Calpin,
  • Sohail Cheema,
  • Elaine Cheng,
  • Brian Chisamore,
  • Evelyn Constantin,
  • Karoon Danayan,
  • Paul Das,
  • Anh Do,
  • Kathleen Doukas,
  • Anne Egger,
  • Allison Farber,
  • Amy Freedman,
  • Sloane Freeman,
  • Sharon Gazeley,
  • Dan Ha,
  • Laura Hanson,
  • Leah Harrington,
  • Sheila Jacobson,
  • Lukasz Jagiello,
  • Gwen Jansz,
  • Paul Kadar,
  • Florence Kim,
  • Holly Knowles,
  • Bruce Kwok,
  • Sheila Lakhoo,
  • Fok-Han Leung,
  • Alan Li,
  • Patricia Li,
  • Jessica Malach,
  • Roy Male,
  • Vashti Mascoll,
  • Aleks Meret,
  • Rosemary Moodie,
  • Maya Nader,
  • Katherine Nash,
  • Sharon Naymark,
  • James Owen,
  • Kifi Pena,
  • Navindra Persaud,
  • Andrew Pinto,
  • Michelle Porepa,
  • Vikky Qi,
  • Nasreen Ramji,
  • Danyaal Raza,
  • Alana Rosenthal,
  • Katherine Rouleau,
  • Caroline Ruderman,
  • Janet Saunderson,
  • Vanna Schiralli,
  • Michael Sgro,
  • Hafiz Shuja,
  • Susan Shepherd,
  • Barbara Smiltnieks,
  • Cinntha Srikanthan,
  • Carolyn Taylor,
  • Stephen Treherne,
  • Fatima Uddin,
  • Meta van den Heuvel,
  • Joanne Vaughan,
  • Thea Weisdorf,
  • Sheila Wijayasinghe,
  • Peter Wong,
  • John Yaremko,
  • Ethel Ying,
  • Elizabeth Young,
  • Michael Zajdman,
  • Farnaz Bazeghi,
  • Vincent Bouchard,
  • Marivic Bustos,
  • Charmaine Camacho,
  • Dharma Dalwadi,
  • Tarandeep Malhi,
  • Sharon Thadani,
  • Laurie Thompson,
  • Mary Aglipay,
  • Imaan Bayoumi,
  • Sarah Carsley,
  • Katherine Cost,
  • Karen Eny,
  • Theresa Kim,
  • Laura Kinlin,
  • Jessica Omand,
  • Shelley Vanderhout,
  • Leigh Vanderloo,
  • Bryan Boodhoo,
  • Olivia Chan,
  • David W.H. Dai,
  • Judith Hall,
  • Karen Pope,
  • Rita Kandel,
  • Michelle Rodrigues,
  • Hilde Vandenberghe,
  • Gita Wahi,
  • Vinusha Gunaseelan,
  • Denis Leuc

DOI
https://doi.org/10.1136/bmjpo-2020-000635
Journal volume & issue
Vol. 4, no. 1

Abstract

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Objectives This study aimed to evaluate the association between maternal ethnicity and iron deficiency (ID) in early childhood, and to evaluate whether infant feeding practices linked to ID differ between maternal ethnic groups.Methods This was a cross-sectional study of healthy children 1–3 years of age. Adjusted multivariable logistic regression analyses were used to evaluate the association between maternal ethnicity and ID (serum ferritin <12 µg/L) and the association between maternal ethnicity and five infant feeding practices (breastfeeding duration; bottle use beyond 15 months; current formula use; daily cow’s milk intake >2 cups; meat consumption).Results Of 1851 children included, 12.2% had ID. Compared with the European referent group, we found higher odds of ID among children of South Asian and West Asian/North African maternal ethnicities, and lower odds of ID among children of East Asian maternal ethnicity. Statistically significant covariates associated with higher odds of ID included longer breastfeeding duration and daily cow’s milk intake >2 cups. Current infant formula use was associated with lower odds of ID. Children of South Asian maternal ethnicity had higher odds of bottle use beyond 15 months of age and lower odds of meat consumption.Conclusions We found increased odds of ID among children of South Asian and West Asian/Northern African maternal ethnicities. We found a higher odds of feeding practices linked to ID in children of South Asian maternal ethnicity, but not in children of West Asian/North African maternal ethnicity. Culturally tailored approaches to providing guidance to parents on healthy infant feeding practices may be important to prevent ID in early childhood.Trial registration number NCT01869530.