Avaliação de diferentes esquemas de suplementação medicamentosa com ferro e vitamina a no tratamento e prevenção da anemia ferropriva em crianças no segundo ano de vida

Abstract

magnitude in Brazil and in the world, affecting mainly children and pregnancy. In the treatment of this nutritional deficiency, the association of vitamin A with iron has been tested in order to improve treatments efficiency, observing positive results as anemias prevalence reduction and increase on the hemoglobin concentration in children. this study had the objective to investigate the efficacy of different schemes of medicative supplementation with vitamin A and iron in the treatment and prevention of iron deficiency anemia in children during the second year of life. This is an randomized clinical trial that children was accompaniedduring 12 weeks. At the beginning it was assessed 158 children, although because of the losses during the months of accompaniment, the number of children that had all the completed assessments was 84. The children was separated in four groups: AI Group with 3 mg/kg/day of elementary iron in iron hydroxide form, AII Group with 3 mg/kg/day of elementary iron in iron hydroxide form added to 1.000UI of palmitate retinol dairy, NI Group with 1 mg/kg/day of elementary ironNII Group with 1 mg/kg/day of elementary iron added to 1.000UI of palmitate retinol dairy, the first two groups were anemic children and the others nonanemic children. It was considered anemic children that ones that had hemoglobin < 11g/dL. Beyond the laboratorial parameters, it was assessed the dietetics and anthropometric parameters too, as well as it was obtained informations about the pregnancy and the birth, socioeconomics conditions and habitation, supplements intakes and others. This study was approved by the ethics committee of theUFMG and UFV Universities. It was utilized the Poisson Model in the association of anemia to others variables of the study. The effect of intervention was observed through chi square tests, Mann-Whitney e Wilcoxon. The anemia in infancy was associated to the date of prenatal begginnig, use of iron compost in the pos 13 childbirth by mother, fathers work condition preceding, utilization of iron compost the child and the period of breast-feeding. In relation to the dietetics parameters, the medium intake of vitamin C, calcium, vitamin A, iron and iron density was 47,8mg; 753,9mg; 518,3mg; 5,2g and 4,4mg/1000Kcal; respectively. However, the perceptual of infants with the intake under the EAR orAI was 8,7; 33,7; 9,6; 17,3; 31,7% vitamin C, calcium, vitamin A, iron and iron density, respectively. In relation to the impact of supplementation, it was observed that the supplementation reduced the anemia prevalence and improved some laboratorial parameters of nutritional state of iron, although without differences in statistics between the groups. By the anthropometric point of view it was observed that it was not any difference of growing in the groups. In relation to the intercurrences and positives effects, it was observed the mayor predominance in positives cases of supplementation then the negative ones. The results demonstrates the importance of maternal nutrition, the observation during the pregnancy and the iron supplementation during the pregnancy, as well as thenutritional adequation in childhood as mechanisms to prevent iron deficiency anemia. Although, the hypothesis that the vitamin A associated to iron had better efficacy in the treatment and prevention of anemia in children had not been confirmed. Because of this, new studies is suggested with children that really has vitamin A deficiency, tests with others doses and a longer period of supplementation, as well as studies with others minerals and vitamins supplementation associated to the iron in order to try to get a better efficiency in the medicamental treatment.