Current trends CDC Criteria for anemia in children and childbearing-aged women

Article Abstract:

Screening for anemia is most often done by measurements of hemoglobin (Hg) and erythrocyte (red blood cell) levels in the blood; the latter value is known as hematocrit (Hct). The criteria for the presence of anemia are determined by cutoff levels. Since the normal levels vary among men, women, children and pregnant women, these criteria must be specific for age, sex and stage of pregnancy (if applicable). The Centers for Disease Control (CDC) have formulated new reference criteria, establishing the anemia cutoff levels for children, nonpregnant women and men. The blood values of children change with age, and therefore these values are age-specific. In pregnant women, Hg and Hct levels decline in the early part of the first trimester, reach their lowest normal point near the end of the second trimester, and begin to rise during the third trimester. The anemia cutoffs have been set at month-specific values for Hb; trimester specific levels have also been established. Another normal variation of Hg and Hct involves altitude and smoking. People living at higher altitudes than 3,300 feet normally have higher Hg and Hct levels than those living near sea level; this may lead to underdiagnosis of anemia. Similar effects are found in smokers. Values that adjust for altitude and/or smoking have been determined, as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Anemia, Hemoglobin, Hemoglobins, Hematocrit

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Height and weight following lead poisoning in childhood

Article Abstract:

Lead poisoning in children can cause growth retardation, even at low levels of toxicity. The long-term effects of lead on the height and weight of 104 lead-poisoned children were studied. Blood lead levels in the children with lead poisoning ranged from 4.82 to 22.73 (micromoles per liter); in their unexposed siblings (27 children) lead levels were 0.48 to 1.88. The height, weight and blood lead concentrations were measured one and six years after initial treatment for lead toxicity. The height and weight of the children were evaluated using standard growth charts. At the one year evaluation, the average lead concentration was 1.68 and 70 percent of the patients and their siblings were in the 50th to 95th percentiles for height and weight. At the six year evaluation the average lead concentration was less than 1.20; height and weight percentiles for patients and siblings were similar to those found at the earlier assessment. It was concluded that lead poisoning did not affect height and weight, and the children who had lead toxicity developed growth parameters similar to those of their unaffected siblings. Among the study group, the genetic predisposition for height and weight was not altered by mild or severe lead poisoning in early childhood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Children, Growth, Body weight, Stature, Body height

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Lead screening at pediatric teaching programs

Article Abstract:

Lead poisoning continues to occur in children, particularly among families of low socioeconomic status. The Centers for Disease Control and The Academy of Pediatrics have established new guidelines for the prevention of lead poisoning in children, since evidence has emerged that levels of lead even lower than previously stated can be toxic to children. Although both agencies state the ideal criteria for screening, there is no central collection and interpretation of results of lead poisoning episodes. Additionally, there is much leeway in determining which children to screen. It is not clear whether these recommendations are being integrated in inner city screening programs. To see how these programs are being implemented, the directors of 22 pediatric teaching programs in urban communities were questioned. Only 27 percent of the programs met all the criteria for lead screening, with 45 percent beginning screening for children after the age of 12 months, when harm may have already occurred. Half of the programs lacked coordination of results and follow-up. It is concluded that many of the criteria set in established screening guidelines are not being met by teaching institutions. (Consumer Summary produced by Reliance Medical Information, Inc.)

American Academy of Pediatrics

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