Anemia - Iron-Deficiency (Pediatric)

Definition

Iron-deficiency anemia (IDA) in children is a condition characterized by insufficient iron availability to meet the body’s requirements, leading to decreased hemoglobin synthesis and reduced oxygen-carrying capacity.

Epidemiology

• Most common nutritional deficiency worldwide in children
• Highest prevalence in infants, toddlers (6–24 months), and adolescent girls
• More common in low- and middle-income countries
• Associated with low birth weight, premature birth, and inadequate dietary iron intake
• Incidence decreases with iron-fortified foods and supplementation programs

Etiology

• Inadequate dietary iron intake
• Increased iron requirements during growth spurts
• Blood loss: gastrointestinal (hookworm, bleeding disorders), hematuria, menorrhagia in adolescents
• Malabsorption: celiac disease, inflammatory bowel disease
• Premature birth or low birth weight limiting iron stores
• Chronic illness or frequent blood sampling in hospitalized children

Pathophysiology

• Iron deficiency leads to decreased hemoglobin synthesis
• Reduced oxygen transport capacity results in tissue hypoxia
• Bone marrow produces smaller, hypochromic red blood cells (microcytic, hypochromic anemia)
• Compensatory mechanisms: increased heart rate and cardiac output
• Chronic deficiency affects neurodevelopment and immune function
• Iron absorption increases in response to deficiency but may be insufficient if intake remains low