Reticulocyte hemoglobin content testing for iron deficiency in healthy toddlers

Objectives: To investigate reticulocyte hemglobin content (CHr) as a primary screening test to detect iron deficiency (ID) in healthy toddlers. Demographic and dietary risk factors associated with ID were studied for an association with low CHr. Methods: This was a prospective cross-sectional study of healthy toddlers aged 12 to 36 months coming to well-child visits at two military pediatric ambulatory clinics in the Washington, DC, area from August 2006 to November 2007. Data were collected on medical, demographic, and dietary intake by parental questionnaire. A sample of blood was drawn from each subject for complete blood count and CHr. A logistic regression model was used to determine which factors may be predictive of ID. Results: A total of 144 children were studied. An abnormal low CHr of 27.5 was identified in 18.8% of our toddler population. Two variables were determined to be independent predictors of low CHr; an age of 12 to 23 months and black race. Conclusions: Used alone as a primary screening marker, CHr identified a high prevalence of ID in our population of toddlers. Black race and younger age were associated with a lower CHr. Larger studies are needed to confirm these findings.