(P10-105-24) Hemoglobin Thresholds to Define Anemia Among Healthy Infants Aged 0–5 Months in China: A Population-Based Study

Objectives: To explore the hemoglobin (Hb) thresholds for defining anemia among healthy infants aged 0-5 months in China.

Methods: "National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC)" is a nationwide population-based cross-sectional study. Hemoglobin was measured by using Hemocue 201+ for infants under 6 mos. Age-specific hemoglobin distribution was constructed for “healthy infants”, who were defined as having adequate iron reserves at birth, exclusively breastfed (EBF), normal weight-for age Z score (WAZ) and weight growth velocity , normal neuropsychological development, and not suffering acute and chronic diseases. Generalised additive model for location scale and shape (GAMLSS) was adopted to fit the Hb percentile in infants aged 0-5 months in China. The 5th percentile of Hb distribution was defined as the Hb threshold for the diagnosis of anemia among month-specific group.

Results: Totally 10174 infants aged 0-5 months completed the CNHSC survey, of which 2814 healthy infants aged 0-5 month were included in analysis sample. The median Hb values of infants aged 0, 30, 60, 90, 120, 150, and 180 days were 131.3 g/L, 123.7, 116.7 g/L, 117.1 g/L, 119.4 g/L, 118.8 g/L, and 117.8 g/L, respectively. Hb value peaked at birth, and gradually decreased to the nadir at around 60 days after birth. Then Hb level rose and reached a plateau. The 5th percentile of Hb was 103.3 g/L, 97.1 g/L, 94.9 g/L, 98.3 g/L, 99.8 g/L and 98.8 g/L in the 0-month, 1-month, 2-month, 3-month, 4-month, and 5-month groups , respectively.

Conclusions: To our knowledge, the threshold of anemia in infants aged 0-5 months was firstly established based on a nationwide population-based study in China. Hb thresholds to define anemia were 103.3 g/L, 97.1 g/L, 94.9 g/L, 98.3 g/L, 99.8 g/L and 98.8 g/L in the 0-month, 1-month, 2-month, 3-month, 4-month, and 5-month groups , respectively.

Funding Sources: This work was supported by the National Special Program for Science & Technology Basic Resources Investigation of China [Grant No. 2017FY101100, 2017FY101101, 2017FY101102, 2017FY101103, 2017FY101104, 2017FY101105,
2017FY101106, and 2017FY101107