{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:53:33Z","timestamp":1773251613590,"version":"3.50.1"},"reference-count":72,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"John L. Beard Endowment"},{"name":"College of Health and Human Development Endowment Funds for Professional Development\/Dissertation Research"},{"name":"Clinical and Translational Sciences Institute, Translational Summer Fellowship"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Children in foster care are classified as a highly vulnerable population and struggle with both physical and mental health problems. Medical conditions, like poor nutritional status, remain understudied in children in foster care. To our knowledge, few studies in children in U.S. foster care have quantified the prevalence of anemia, and no studies have examined the association between anemia status and relevant developmental and behavioral outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective\/aims<\/jats:title>\n<jats:p>(1) To determine the prevalence of anemia among children in or adopted from Pennsylvania foster care, between the ages of six months to ten years and (2) To examine if a child\u2019s anemia status is associated with greater odds of relevant developmental and behavioral diagnoses.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a secondary data analysis utilizing the <jats:italic>Medicaid Analytic eXtract<\/jats:italic> database between 2010\u20132015. Children six months\u2013ten years were included in the analysis if they were in or had been adopted from Pennsylvania foster care. Logistic regression was used to calculate adjusted odds ratios (AOR) with 95% confidence intervals for the association between iron status and health outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 50,311 children were included in our sample, of which 1,365 children (2.7%) were diagnosed with anemia. Children diagnosed with anemia had greater odds of delayed milestones (AOR: 2.38 [1.64\u20133.45]), specific delays in development (AOR: 1.59 [1.23\u20132.07]), adjustment disorder (AOR: 1.59 [1.06\u20132.39]), and irritability (AOR: 10.57 [3.36\u201333.25]), than children not diagnosed with anemia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The prevalence of anemia among children between six months\u2013ten years in or adopted from the Pennsylvania foster care system is within the national rate of U.S. childhood anemia. Odds of several relevant developmental and behavioral diagnoses were greater among children diagnosed with anemia than children who were not.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0289951","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T17:27:55Z","timestamp":1692293275000},"page":"e0289951","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Iron status, development, and behavior in young children in the Pennsylvania foster care 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