Prevalence of Iron Deficiency and Iron Deficiency Anaemia in Low Birth Weight Infants on Follow-up at Kenyatta National Hospital

Abstract

Background Iron deficiency anaemia (IDA) is a common micronutrient deficiency that contributes to morbidity and mortality among low birth weight infants; with significant, long-term effects on memory, cognition and auditory brain responses. Prevention is achieved by early initiation of iron supplementation as prophylaxis against IDA. Kenyan national guidelines recommend supplementation of elemental iron for infants born weighing less than 2000 grams, starting at 4 weeks of age. Objectives The aim of this study was to determine the prevalence of iron deficiency anaemia among low birth weight infants aged 12 months and below following discharge from the New Born Unit. It also sought to identify factors influencing the uptake of iron supplements among LBW infants as prophylaxis against IDA. Methodology A cross-sectional study was conducted among babies born weighing 2000 grams and below aged less than one year, on follow-up at various newborn, outpatient clinics at Kenyatta National Hospital. 110 infants were recruited into the study. Socio-demographic and clinical details of the infant-mother dyads were obtained and blood samples collected for analysis of Hemoglobin, MCV and Transferrin receptor levels as measures of levels of deficiencies of iron. Prevalence of ID and IDA was calculated as a percentage of normal levels of hemoglobin, MCV and estimated iron levels. Bivariate and Multivariate analyses were done to find out the various factors associated with the uptake of iron supplements. Results The prevalence of ID and IDA among LBW infants on follow-up at KNH was at 3.6% {95% Confidence Interval (CI) 0%-7%} and 14.5% (95% CI 8%-21%) respectively. However, the total prevalence of anaemia was at 26.4% (95% CI 18%-35%) with most infants receiving iron prophylaxis at high dosages. The factors that positively influenced the uptake of iron supplementation were maternal factors which included; >4 ANC visits(AOR=2.9; 95% CI 1.74-4.77), gestation at 1st visit at <18 weeks(AOR 8.12; 95%CI 4.59-14.38), and prior history of pregnancy losses (AOR=3.91; 95%CI 1.40-10.89); infant factors (age<3 months {AOR 3.77; 95%CI 1.81-7.92}, birth weight <1800g {AOR 5.03 95%CI 1.13-22.40} and provision of health education (AOR 20.28, 95% CI 9.163-41.883). Conclusion and Recommendation While the prevalence of ID and IDA among low birth weight infants on follow-up at KNH was low, the use of iron supplements till the age of one year should be emphasized in line with the national guidelines, as this is crucial in the prevention of ID and IDA in LBW infants.