Association between febrile seizures and iron deficiency anemia in infants and preschool children: a Meta-analysis

doi:10.3877/cma.j.issn.2095-9133.2019.01.005

Abstract

Abstract:

Objective

To determine the relationship between febrile seizures and iron deficiency anemia in infants and preschool children by using a meta-analysis of published articles.

Methods

The Chinese and English electronic databases were used in this study, such as PubMed, Web of science, MEDLINE, Wanfang Data Knowledge Service Platform, China Knowledge Network Database (CNKI), VIP Database, and Cochrane Library Database, collected from January 1990 to September 2017. The published articles about the association between febrile seizures and iron deficiency anemia in infants and preschool children between 3 months and 6 years old were reviewed. The search terms in Chinese were "iron deficiency" or "serum iron" or "serum ferritin" or "transferrin" or "iron deficiency anemia" and "hot convulsion" ; the English search terms were anemia, iron-deficiency and seizures, febrile or pyrexial seizure or pyrexial convulsion. The literature was screened and extracted by two investigators according to the inclusion and exclusion criteria. The Newcastle-Ottawa Scale (NOS) was used for literature quality assessment. Stata SE 12.0 software was used for meta-analysis of whether iron deficiency anemia was a risk factor for children with febrile seizures, calculation of odds ratio (OR), and subgroup analysis based on different diagnostic criteria for iron deficiency anemia.

Results

A total of 89 relevant literatures were detected in this study. After screening, 26 articles that met the inclusion and exclusion criteria were finally included for meta-analysis. The results of the analysis showed that febrile seizures were associated with iron deficiency anemia [OR=2.24, 95% CI (1.758, 2.854), P<0.05].

Conclusion

Iron deficiency anemia is one of the risk factors for febrile seizures in infants and preschool children.

Key words: Iron deficiency anemia, Febrile convulsions, Infant, Preschool children

Yulu Gan, Jin Yu, Jingyi Fan. Association between febrile seizures and iron deficiency anemia in infants and preschool children: a Meta-analysis[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2019, 05(01): 18-25.

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Figures/Tables 7

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第一作者	出版年份	国家	月龄(月)	ID诊断标准	病例组(例)	对照组(例)	病例组ID发病率(%)	对照组ID发病率(%)	质量评估(分)
Kobrinsky NL^[46]	1995	美国	6～36	FEP>0.8 μmoL/L	26	25	8.7(2/23)	40.0(10/25)	5
Pisacane A^[3]	1996	意大利	6～24	Hb<105 g/L，SI<5.4 mmoL/L	146	146	30.1(44/146)	14.4(21/146)	3
Wang XS^[31]	1998	中国	3～96	Hb<110 g/L，SI<5.4 mmoL/L	75	75	65.3(49/75)	32.0(24/75)	4
Li YH^[30]	1999	中国	6～108	Hb<110 g/L, SI<5.4mmol/L SF<12 μg/L	200	200	44.0(88/200)	48.0(96/200)	7
Zhang X^[32]	2001	中国	4～108	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	361	390	6.1(22/361)	4.4(17/390)	6
Daoud AS^[4]	2002	约旦	3～72	Hb<110 g/L，SF<30 μg/L	132	132	15.1(20/132)	17.3(23/132)	6
Bao L^[28]	2003	中国	6～36	Hb<110 g/L，MCV<80 fL	100	100	39.0(39/100)	28.0(28/100)	5
Chen H^[26]	2005	中国	5～60	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	154	154	63.6(98/154)	24.7(38/154)	6
Feng WJ^[39]	2006	中国	7～60	Hb<110 g/L，MCV<80 fL	75	75	58.6(44/75)	30.7(23/75)	6
Wang GF^[37]	2008	中国	3～108	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	80	160	68.8(55/80)	47.7(553/1 160)	6
Bidabadi E^[43]	2009	伊朗	6～60	Hb，HCT，MCV，MCHC，RBC，SI为相应年龄2个标准差的正常值and TIBC>430 mcg/dL，MCV<70 fL (6～23个月)，MCV<75 fL(24～60个月)	200	200	44.0(88/200)	48.0(96/200)	5
Hartfield DS^[8]	2009	加拿大	6～36	MCV<70 fL，RDW > 15.6%	88	76	61.4(54/88)	43.4(33/76)	6
Ma FF^[29]	2009	中国	5～60	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	80	78	70.0(56/80)	30.8(24/78)	6
Lu CX^[36]	2009	中国	6～72	Hb<110 g/L，SI<5.4 mmoL/L	76	61	34.2(26/76)	18.0(11/61)	5
Jun YS^[9]	2010	韩国	9～24	Hb<105 g/L，MCV<70 fL	105	1347	36.2(38/105)	8.9(120/1 347)	4
Richard I^[49]	2010	肯尼亚	3～156	SF<12 mg/mL(CRP<10 mg/mL)或SF<30 mg/mL(CRP≥10 mg/mL)	60	935	58.3(35/60)	40.1(375/935)	5
Ma JF^[35]	2012	中国	5～72	Hb<110 g/L，SI<5.4 mmol/L，SF<12μg/L	50	595	64.0(32/50)	42.5(253/595)	5
Kumari P^[10]	2012	中国	6～36	Hb<110g/L，RDW>15%，SF<12 ng/mL	20	312	55.0(11/20)	36.9(115/312)	5
Chen JL^[40]	2012	中国	6～72	Hb<110 g/L，MCV<80 fL	123	112	59.3(73/123)	19.6(22/112)	6
Zhu W^[38]	2012	中国	7～60	Hb<110 g/L，SI<5.4mmol/L，SF<12 μg/L	104	98	46.2(48/104)	19.4(19/98)	6
Yang QB^[34]	2013	中国	6～60	Hb<110 g/L，SI<5.4 mmol/L	143	145	12.6(18/143)	5.5(8/145)	6
Li FC^[27]	2014	中国	3～72	Hb<110 g/L，SI<5.4 mmol/L，SF<12 μg/L	80	75	62.5(50/80)	43.7(33/75)	5
Wang SJ^[33]	2015	中国	6～36	Hb<105 g/L，SF<12 μg/L，FEP<40 μg/dL	80	1080	68.8(55/80)	51.7(558/1 080)	6
Raju MS^[19]	2015	印度	6～60	Hb≤110g/L，SF≤30 ng/mL	29	26	48.3(14/29)	26.9(7/26)	6
Sharif MR^[21]	2015	伊朗	6～60	Hb<115 g/L，SI >40 μg/dL，	106	94	37.7(40/106)	20.2(19/94)	6
Unver O^[22]	2015	土耳其	6～60	Hb<110 g/L，SF<30 ng/mL，SI<30 μg/dL	78	76	60.3(47/78)	42.1(32/76)	6

第一作者	出版年份	国家	月龄(月)	ID诊断标准	病例组(例)	对照组(例)	病例组ID发病率(%)	对照组ID发病率(%)	质量评估(分)
Kobrinsky NL^[46]	1995	美国	6～36	FEP>0.8 μmoL/L	26	25	8.7(2/23)	40.0(10/25)	5
Pisacane A^[3]	1996	意大利	6～24	Hb<105 g/L，SI<5.4 mmoL/L	146	146	30.1(44/146)	14.4(21/146)	3
Wang XS^[31]	1998	中国	3～96	Hb<110 g/L，SI<5.4 mmoL/L	75	75	65.3(49/75)	32.0(24/75)	4
Li YH^[30]	1999	中国	6～108	Hb<110 g/L, SI<5.4mmol/L SF<12 μg/L	200	200	44.0(88/200)	48.0(96/200)	7
Zhang X^[32]	2001	中国	4～108	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	361	390	6.1(22/361)	4.4(17/390)	6
Daoud AS^[4]	2002	约旦	3～72	Hb<110 g/L，SF<30 μg/L	132	132	15.1(20/132)	17.3(23/132)	6
Bao L^[28]	2003	中国	6～36	Hb<110 g/L，MCV<80 fL	100	100	39.0(39/100)	28.0(28/100)	5
Chen H^[26]	2005	中国	5～60	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	154	154	63.6(98/154)	24.7(38/154)	6
Feng WJ^[39]	2006	中国	7～60	Hb<110 g/L，MCV<80 fL	75	75	58.6(44/75)	30.7(23/75)	6
Wang GF^[37]	2008	中国	3～108	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	80	160	68.8(55/80)	47.7(553/1 160)	6
Bidabadi E^[43]	2009	伊朗	6～60	Hb，HCT，MCV，MCHC，RBC，SI为相应年龄2个标准差的正常值and TIBC>430 mcg/dL，MCV<70 fL (6～23个月)，MCV<75 fL(24～60个月)	200	200	44.0(88/200)	48.0(96/200)	5
Hartfield DS^[8]	2009	加拿大	6～36	MCV<70 fL，RDW > 15.6%	88	76	61.4(54/88)	43.4(33/76)	6
Ma FF^[29]	2009	中国	5～60	Hb<110 g/L，SI<5.4 mmoL/L，SF<12 μg/L	80	78	70.0(56/80)	30.8(24/78)	6
Lu CX^[36]	2009	中国	6～72	Hb<110 g/L，SI<5.4 mmoL/L	76	61	34.2(26/76)	18.0(11/61)	5
Jun YS^[9]	2010	韩国	9～24	Hb<105 g/L，MCV<70 fL	105	1347	36.2(38/105)	8.9(120/1 347)	4
Richard I^[49]	2010	肯尼亚	3～156	SF<12 mg/mL(CRP<10 mg/mL)或SF<30 mg/mL(CRP≥10 mg/mL)	60	935	58.3(35/60)	40.1(375/935)	5
Ma JF^[35]	2012	中国	5～72	Hb<110 g/L，SI<5.4 mmol/L，SF<12μg/L	50	595	64.0(32/50)	42.5(253/595)	5
Kumari P^[10]	2012	中国	6～36	Hb<110g/L，RDW>15%，SF<12 ng/mL	20	312	55.0(11/20)	36.9(115/312)	5
Chen JL^[40]	2012	中国	6～72	Hb<110 g/L，MCV<80 fL	123	112	59.3(73/123)	19.6(22/112)	6
Zhu W^[38]	2012	中国	7～60	Hb<110 g/L，SI<5.4mmol/L，SF<12 μg/L	104	98	46.2(48/104)	19.4(19/98)	6
Yang QB^[34]	2013	中国	6～60	Hb<110 g/L，SI<5.4 mmol/L	143	145	12.6(18/143)	5.5(8/145)	6
Li FC^[27]	2014	中国	3～72	Hb<110 g/L，SI<5.4 mmol/L，SF<12 μg/L	80	75	62.5(50/80)	43.7(33/75)	5
Wang SJ^[33]	2015	中国	6～36	Hb<105 g/L，SF<12 μg/L，FEP<40 μg/dL	80	1080	68.8(55/80)	51.7(558/1 080)	6
Raju MS^[19]	2015	印度	6～60	Hb≤110g/L，SF≤30 ng/mL	29	26	48.3(14/29)	26.9(7/26)	6
Sharif MR^[21]	2015	伊朗	6～60	Hb<115 g/L，SI >40 μg/dL，	106	94	37.7(40/106)	20.2(19/94)	6
Unver O^[22]	2015	土耳其	6～60	Hb<110 g/L，SF<30 ng/mL，SI<30 μg/dL	78	76	60.3(47/78)	42.1(32/76)	6

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