INTERNATIONAL JOURNAL
OF MEDICAL SCIENCES
ISSN NUMBER: 2692 - 5206
Volume 5,September ,2025
13
IRON DEFICIENCY ANEMIA IN CHILDREN: PATHOPHYSIOLOGICAL
MECHANISMS AND CLINICAL MANAGEMENT
Maksudova Khakima Fayzullayevna
Andijan State Medical Institute, Uzbekistan
Abstract:
Iron deficiency anemia (IDA) is the most prevalent nutritional disorder in children
worldwide, significantly impacting growth, cognitive development, and overall health. The
condition arises from inadequate dietary intake, impaired absorption, or increased iron
requirements during periods of rapid growth. This article reviews the pathophysiological
mechanisms of IDA in children, its clinical manifestations, and current strategies for diagnosis
and management. Evidence from recent studies indicates that while oral iron supplementation
remains the first-line treatment, adherence and gastrointestinal side effects pose challenges. A
deeper understanding of iron metabolism in childhood highlights the importance of preventive
strategies, including dietary interventions and fortification programs.
Keywords:
Iron deficiency anemia; Pediatrics; Pathophysiology; Childhood nutrition;
Hemoglobin; Iron supplementation
Introduction
Iron deficiency anemia is one of the most common hematological conditions in pediatrics,
affecting an estimated 40–50% of children in developing countries. Iron is essential for
hemoglobin synthesis, oxygen transport, and neurological development. In children, rapid
physical growth, poor nutritional intake, and recurrent infections increase the risk of iron
deficiency. IDA is associated with impaired school performance, reduced immunity, and long-
term cognitive deficits, making it a pressing global health problem. Understanding the
pathophysiology of IDA in children is crucial for early recognition and effective management.
Iron deficiency anemia (IDA) remains the most common nutritional and hematological disorder
in the pediatric population, affecting both developed and developing countries. According to the
World Health Organization, nearly half of preschool-aged children worldwide suffer from
anemia, with iron deficiency being the leading cause. The high prevalence in childhood is linked
to the rapid pace of growth and development, which places increased demands on iron stores,
coupled with dietary insufficiencies and recurrent infections. The consequences of IDA in
children extend beyond hematological alterations, influencing growth velocity, neurocognitive
development, behavior, and overall quality of life.
The importance of iron in pediatric physiology is multifaceted. Iron is not only a critical
component of hemoglobin for oxygen transport, but also plays a central role in enzymatic
systems, neurotransmitter synthesis, and energy metabolism. During the first years of life, when
the brain is undergoing rapid growth and synaptic formation, adequate iron levels are essential
INTERNATIONAL JOURNAL
OF MEDICAL SCIENCES
ISSN NUMBER: 2692 - 5206
Volume 5,September ,2025
14
for optimal neurological development. Deficiency during this sensitive period has been
associated with irreversible cognitive impairments, delayed motor milestones, and decreased
learning capacity.
Pathophysiologically, IDA is characterized by the depletion of iron stores, impaired
erythropoiesis, and the development of microcytic hypochromic anemia. This leads to reduced
oxygen delivery to tissues, resulting in fatigue, pallor, poor appetite, and increased susceptibility
to infections. The underlying causes of IDA in children are multifactorial: insufficient iron intake
due to poor dietary diversity, malabsorption related to gastrointestinal conditions, blood loss
from parasitic infections, and heightened iron requirements during periods of growth spurts. In
low- and middle-income countries, socioeconomic factors such as poverty, food insecurity, and
limited access to healthcare further exacerbate the burden.
The public health implications of childhood IDA are profound. Beyond individual morbidity,
widespread anemia impacts educational performance, labor productivity in adulthood, and
national economic development. Although effective preventive strategies such as food
fortification and supplementation programs exist, challenges remain in ensuring adequate
coverage, adherence, and sustainability. Moreover, the clinical management of IDA in children
requires balancing efficacy with safety, as conventional oral iron supplementation is often
limited by gastrointestinal side effects and poor compliance.
Given these concerns, a deeper exploration of the pathophysiological mechanisms, risk factors,
and clinical management of iron deficiency anemia in children is essential. By integrating
advances in pediatric hematology with public health approaches, it is possible to design more
effective interventions to reduce the global burden of this condition. This article aims to review
current knowledge on the mechanisms of IDA in children, its clinical implications, and evidence-
based management strategies.
Methods
This narrative review was conducted using databases including PubMed, Scopus, and Web of
Science, covering literature published from 2015 to 2024. Search terms included “iron deficiency
anemia,” “children,” “pathophysiology,” “management,” and “nutrition.” Studies included
randomized controlled trials, cohort studies, and systematic reviews focusing on pediatric
populations. Data on risk factors, pathophysiological mechanisms, diagnostic approaches, and
treatment strategies were extracted and synthesized.
Results
The literature highlights that iron deficiency in children results primarily from three mechanisms:
inadequate dietary intake, malabsorption, and increased physiological demand. Iron is absorbed
mainly in the duodenum, and conditions such as celiac disease or chronic diarrhea can impair
absorption. During periods of rapid growth, particularly infancy and adolescence, iron
requirements exceed dietary supply, predisposing children to anemia.
INTERNATIONAL JOURNAL
OF MEDICAL SCIENCES
ISSN NUMBER: 2692 - 5206
Volume 5,September ,2025
15
Pathophysiologically, iron deficiency disrupts hemoglobin synthesis, leading to microcytic
hypochromic anemia. The reduced oxygen-carrying capacity impairs tissue oxygenation,
contributing to fatigue, delayed psychomotor development, and impaired immunity. Clinical
manifestations include pallor, irritability, poor concentration, and in severe cases, developmental
regression.
Management strategies remain centered on oral iron supplementation, with ferrous sulfate being
the most commonly prescribed preparation. However, gastrointestinal side effects such as
constipation and nausea reduce adherence. Intravenous iron therapy is reserved for severe cases
or those with malabsorption. Preventive strategies, including breastfeeding support, dietary
diversification, and food fortification, have demonstrated significant reductions in IDA
prevalence.
Discussion
The findings emphasize that IDA in children is not only a hematological disorder but also a
developmental challenge with long-term implications. While supplementation remains effective,
public health measures addressing the root causes of nutritional deficiencies are equally vital.
School-based nutrition programs and iron fortification of staple foods have shown promising
outcomes in reducing childhood anemia rates. The role of caregivers and healthcare providers in
early detection through routine screening is critical in preventing severe complications.
Future research should focus on novel iron formulations with improved bioavailability and fewer
side effects, as well as the genetic and epigenetic factors influencing iron metabolism in children.
A multidisciplinary approach combining clinical care, public health interventions, and
community education offers the most effective solution to this persistent problem.
Conclusion
Iron deficiency anemia remains a major global health issue in pediatrics, with significant impacts
on physical growth and cognitive development. Pathophysiological insights demonstrate the
importance of early recognition, effective treatment, and preventive measures. Integrating
clinical strategies with public health initiatives is essential to reduce the global burden of
childhood anemia and improve long-term outcomes.
References:
1. Pasricha S-R, et al. Iron deficiency anemia in young children: epidemiology and
management. Lancet Child Adolesc Health. 2018.
2. World Health Organization. Nutritional anemia in childhood. WHO Report. 2020.
3. Lopez A, et al. Iron deficiency and anemia of chronic disease. N Engl J Med. 2016.
4. Pavord S, et al. Management of iron deficiency anemia in children. Br J Haematol. 2021.
5. Chen O, et al. Novel approaches to iron supplementation in pediatrics. Pediatrics. 2023.
