{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:01:59Z","timestamp":1787284919808,"version":"build-2736575974"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVES:<\/jats:title><jats:p>The American Academy of Pediatrics recommends universal screening for anemia using hemoglobin at 12 months. However, hemoglobin lacks diagnostic accuracy for iron deficiency, and the optimal age for screening has not been determined. Our objective was to assess a screening strategy for iron deficiency using serum ferritin.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We conducted a cross-sectional study of children 1 to 3 years old attending a health supervision visit. We examined the relationship between child age and serum ferritin, age and hemoglobin, hemoglobin and serum ferritin, and the prevalence of elevated C-reactive protein (CRP).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Restricted cubic spline analysis (n = 1735) revealed a nonlinear relationship between age and serum ferritin (P &amp;lt; .0001). A linear spline model revealed that from 12 to 15 months, for each 1-month increase in age, serum ferritin levels decreased by 9% (95% confidence interval [CI]: 5 to 13). From 15 to 24 months, the rate of change was nonsignificant. From 24 to 38 months, for each month increase in age, serum ferritin increased by 2% (95% CI: 1 to 2). For hemoglobin, from 12 to 24 months, the rate of change was nonsignificant. From 24 to 38 months, for each 1-month increase in age, hemoglobin increased by 20% (95% CI: 9 to 32). Compared with the serum ferritin cutoff of &amp;lt;12 \u03bcg\/L, the hemoglobin cutoff of &amp;lt;110 g\/L had a sensitivity of 25% (95% CI: 19 to 32) and a specificity of 89% (95% CI: 87 to 91). Elevated CRP \u226510 mg\/L occurred in 3.3% (95% CI: 2.5 to 4.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Screening for iron deficiency using serum ferritin at 15 or 18 months may be a promising strategy. For children at low risk for acute inflammation, concurrent measurement of CRP may not be necessary.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2018-2095","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T13:25:30Z","timestamp":1543411530000},"source":"Crossref","is-referenced-by-count":27,"title":["Screening for Iron Deficiency in Early Childhood Using Serum Ferritin in the Primary Care Setting"],"prefix":"10.1542","volume":"142","author":[{"given":"Hannah","family":"Oatley","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia M.","family":"Borkhoff","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and"},{"name":"Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Macarthur","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine,"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and"},{"name":"Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navindra","family":"Persaud","sequence":"additional","affiliation":[{"name":"Joannah & Brian Lawson Centre for Child Nutrition, and"},{"name":"Departments of Family Medicine and"},{"name":"Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine S.","family":"Birken","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine,"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and"},{"name":"Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; and"},{"name":"Joannah & Brian Lawson Centre for Child Nutrition, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon L.","family":"Maguire","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine,"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and"},{"name":"Joannah & Brian Lawson Centre for Child Nutrition, and"},{"name":"Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia C.","family":"Parkin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine,"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and"},{"name":"Sick Kids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; and"},{"name":"Joannah & Brian Lawson Centre for Child Nutrition, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the TARGet Kids! 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