The Indian Journal of Pediatrics

, Volume 79, Issue 12, pp 1592–1596

Addition of Cobalamin to Iron and Folic Acid Improves Hemoglobin Rise in Nutritional Anemia

  • Sudha Chandelia
  • Jagdish Chandra
  • Shashi Narayan
  • Satinder Aneja
  • Har Mohindra Chawla
  • Sunita Sharma
  • Sarika Mrig
Original Article

DOI: 10.1007/s12098-012-0725-9

Cite this article as:
Chandelia, S., Chandra, J., Narayan, S. et al. Indian J Pediatr (2012) 79: 1592. doi:10.1007/s12098-012-0725-9

Abstract

Objective

To assess whether addition of cobalamin (cbl) to iron-folic acid will result in improved response in nutritional anemia.

Methods

This study included 150 children aged between 0.5–5 y having nutritional anemia. Anemia was categorized for severity and red cell morphology. Serum levels of ferritin were obtained in all cases while levels of cbl and folic acid (FA) were done only in children having macrocytic or dimorphic anemia. Children were randomized to receive either iron and FA (Group I) or iron, FA and cbl (Group II). Response to treatment was assessed at 2, 4 and 8 wk.

Results

Of all the 150 patients, iron deficiency was documented in 111 patients. Of the 41 cases in whom, Cbl and FA levels were done, 97.56% and 53.66% had deficiency of cbl and FA respectively. Patients in group II had higher Hb level at 2, 4 and 8 wk (significant at 4 and 8 wk). Percentage Hb rise from baseline Hb was significantly higher in group II (p 0.00). In group II, increase in Hb among cases with macrocytosis and others were similar although percentage increase in Hb was more pronounced among patients with macrocytic anemia or dimorphic anemia. However, this difference was statistically not significant (p = 0.18).

Conclusions

Children receiving cbl in addition to iron and FA showed an improved hematological response.

Keywords

Nutritional anemia Megaloblastic anemia Cobalamin Iron Folic acid Hemoglobin 

Abbreviations

MA

Megaloblastic anemia

Cbl

Cobalamin

FA

Folic acid

Hb

Hemoglobin

M

Male

F

Female

SD

Standard deviation

Copyright information

© Dr. K C Chaudhuri Foundation 2012

Authors and Affiliations

  • Sudha Chandelia
    • 1
    • 4
  • Jagdish Chandra
    • 1
  • Shashi Narayan
    • 2
  • Satinder Aneja
    • 1
  • Har Mohindra Chawla
    • 3
  • Sunita Sharma
    • 2
  • Sarika Mrig
    • 3
  1. 1.Department of PediatricsLady Hardinge Medical College and Associated Kalawati Saran Children’s HospitalNew DelhiIndia
  2. 2.Department of PathologyLady Hardinge Medical College and Associated Kalawati Saran Children’s HospitalNew DelhiIndia
  3. 3.Department of ChemistryIndian Institute of TechnologyNew DelhiIndia
  4. 4.New DelhiIndia

Personalised recommendations