BMJ Paediatrics Open (Apr 2020)
Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
- Tara Kiran,
- Noor Ramji,
- Mary Beth Derocher,
- Margarita Lam-Antoniades,
- 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
Affiliations
- Tara Kiran
- 9 Department of Family and Community Medicine, St. Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada
- Noor Ramji
- Mary Beth Derocher
- Margarita Lam-Antoniades
- Gerald Lebovic
- 9 The Applied Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- Peter Jüni
- 1Institute of Social and Preventive Medicine (ISPM), University of Bern, and CTU Bern, Bern University Hospital, Bern, Switzerland
- Colin Macarthur
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Christopher Allen
- 7 Guy's & St Thomas' Hospital, Kings College, Rayne Institute, London, London, UK
- Julia Thompson
- 5 Children and Young People’s Public Health Team, Sheffield City Council, Sheffield, UK
- Charlie Guiang
- Kevin Thorpe
- 4 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Marty Perlmutar
- 17 Department of Pediatrics, Michael Garron Hospital, Toronto, Ontario, Canada
- Douglas Campbell
- 5Allan Waters Family Simulation Centre, St Michael's Hospital, Toronto, Ontario, Canada
- Andreas Laupacis
- 4 Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Elise Mok
- 2Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Curtis Handford
- Department of Family and Community Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Suzanne Turner
- Christine Koroshegyi
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Catherine S. Birken
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Jonathon L. Maguire
- Sick Kids Research Institute, Toronto, Ontario, Canada
- Ronald Cohn
- Eddy Lau
- Patricia C. Parkin
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Michael Salter
- Shannon Weir
- Patient Partner, Toronto, Ontario, Canada
- Laura N. Anderson
- Cornelia M. Borkhoff
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Charles Keown-Stoneman
- Christine Kowal
- 13 Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Dalah Mason
- 13 Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Murtala Abdurrahman
- Kelly Anderson
- Gordon Arbess
- Jillian Baker
- Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
- Tony Barozzino
- Sylvie Bergeron
- Dimple Bhagat
- Gary Bloch
- family physician
- Joey Bonifacio
- Ashna Bowry
- Caroline Calpin
- Sohail Cheema
- Elaine Cheng
- Brian Chisamore
- Evelyn Constantin
- Department of Pediatrics, Mcgill University, Montreal, Quebec, Canada
- 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
- 2Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Jessica Malach
- Roy Male
- Vashti Mascoll
- Aleks Meret
- Rosemary Moodie
- Maya Nader
- Katherine Nash
- Sharon Naymark
- James Owen
- Kifi Pena
- Navindra Persaud
- Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
- Andrew Pinto
- Michelle Porepa
- Vikky Qi
- Nasreen Ramji
- Danyaal Raza
- 4 Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Alana Rosenthal
- Katherine Rouleau
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- 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
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- John Yaremko
- Ethel Ying
- Elizabeth Young
- Michael Zajdman
- Farnaz Bazeghi
- 2 Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Vincent Bouchard
- Marivic Bustos
- Charmaine Camacho
- Dharma Dalwadi
- Tarandeep Malhi
- Sharon Thadani
- Laurie Thompson
- Mary Aglipay
- 3Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Imaan Bayoumi
- Sarah Carsley
- 1 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Katherine Cost
- Karen Eny
- Theresa Kim
- Laura Kinlin
- Jessica Omand
- Shelley Vanderhout
- Leigh Vanderloo
- Bryan Boodhoo
- Olivia Chan
- 1 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- David W.H. Dai
- Judith Hall
- 10 Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Ontario, Canada
- Karen Pope
- Rita Kandel
- Michelle Rodrigues
- Hilde Vandenberghe
- Gita Wahi
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Vinusha Gunaseelan
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Denis Leuc
- DOI
- https://doi.org/10.1136/bmjpo-2020-000635
- Journal volume & issue
-
Vol. 4,
no. 1
Abstract
ObjectivesThis 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.MethodsThis 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).ResultsOf 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.ConclusionsWe 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 numberNCT01869530.