Percentile curves for hemoglobin and red cellvolume in infnacy and childhood

doi:10.1016/S0022-3476(79)80344-3

The Journal of Pediatrics

Volume 94, Issue 1, January 1979, Pages 26-31

https://doi.org/10.1016/S0022-3476(79)80344-3 Get rights and content

Percentile curves were calculated for hemoglobin and mean corpuscular volume in children between 0.5 and 16 years of age. The curves were derived from several populations of non-indigent white children who lived near sea level. Subjects were excluded from the reference population if they had laboratory evidence of iron deficiency, thalassemia minor, and/or hemoglobinopathy. The final reference populations included 9,946 children for the derivation of the hemoglobin curves and 2,314 for the MCV curves. The percentile curves should be particularly applicable to the diagnosis and screening of iron deficiency and thalassemia minor.

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Furthermore, children in non-slums have a greater likelihood of consuming diverse foods thus improving their chances of vitamin A-rich food intake. Folate deficient children in the four cities were much less as compared to estimates from the past research in India (Dallman and Siimes, 1979; Gomber et al., 1998; Kapil et al., 2015). Children from slums are at a significantly greater risk of folate deficiency compared to non-slum children, irrespective of their age.
Micronutrient malnutrition is an emerging public health concern globally. It affects people of all ages and socioeconomic groups; however, the most marginalized are the worst affected. Using data from the Comprehensive National Nutrition Survey 2016–18, we determined the magnitude of deficiencies (of iron, zinc, vitamin A, folate, vitamins B₁₂ and D) among children and adolescents (1–19 years of age) living in four metropolitan cities of India. Separate estimates by residence in slum and non-slum areas were derived for pre-school and school-aged children and adolescents. The association between each micronutrient deficiency (MND) and place of residence, exposure to progarmmes, socioeconomic, and demographic variables was assessed using Poisson regression. Of all children in the sample, at least seven out of 10 children suffered from some kind of MND. Anaemia was prevalent among all children but at different levels among various age-groups. Folate deficiency was highly prevalent among children in slums whereas deficiencies of vitamin D and zinc were more prevalent among non-slum children. Dietary diversity reduced the risk of deficiencies- Vitamin A in children 1–9, anaemea in 1–4 age, folate in children 5–19. Exposure to government-sponsored nutrition programmes such as mid-day meal, and IFA did not show any significant effect on reducing deficiencies. However, adolescents exposed to IFA supplementation programmes were less likely to be folate deficient. Overall, government schemes that have been running for decades, and intensified lately, are yet to show noticeable positive effect on micronutrient status of children. Nevertheless, differential estimates by slum/non-slum residence and by age-groups calls for devising different strategies for different sub-groups to address the issue of MNDs among children and adolescents. Nutrition education not only for slum residents but also for those from non-slum areas is an urgent need to check the spread of MNDs.
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Macrocytosis is typically defined by RBC with an abnormally large MCV of >100 fl.8 However, the value is lower in children.9 For MCV in children, previously published normative curves were used to define normal age-adjusted values, and any values above the ninety-seventh percentile were considered abnormal.9 For ages above 20 years, the upper limit of normal was defined according to tradition as 100 fl.
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^**: Supported by grants from the National Institutes of Health, Grant No. AM HD 13897, and the Foundation for Pediatric Research in Finland.

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Original articlePercentile curves for hemoglobin and red cellvolume in infnacy and childhood**

Am J Clin Nutr

J Pediatr

J Pediatr

J Pediatr

J Pediatr

Pediatr Clin North Am

J Pediatr

J Pediatr

Blood

Blood

J Pediatr

Hemoglobin levels in children from a biracial southern community

Am J Public Health

Hematology

Original article
Percentile curves for hemoglobin and red cellvolume in infnacy and childhood**