To assess the diagnostic accuracy and to develop prediction tools for iron deficiency in 2-year-old children.
In a national cross-sectional study conducted in primary care pediatricians’ practices throughout France, 2-year-old children were consecutively included (2016-2017). Multivariable logistic regression modeling and bootstrapping were used to develop several clinical models to predict ID (serum ferritin <12 μg/L). These models used the best criteria and combinations among the American Academy of Pediatrics' (AAP) criteria adapted to the European context (n=10), then all potential predictors (n=19). One model was then simplified into a simple prediction tool.
Among 568 included infants, 38 had ID (6.7%). In univariable analyses, no significant association with ID was observed for 8 of the 10 adapted AAP criteria. Three criteria (both parents born outside the European Union, low weight at one year old, and weaning to cow’s milk without supplemental iron) were retained in the “AAP model,” which AUROC, sensitivity, and specificity were 0.62 (95% CI 0.58-0.67), 30% (22-39%) and 95% (92-97%), respectively. Four criteria were retained in a newly derived “simple prediction tool” (≥one criterion among the three previous plus duration of iron-rich formula consumption <12 months), which AUROC, sensitivity, and specificity were 0.72 (0.65-0.79), 63% (47-80%) and 81% (70-91%), respectively.
(s): All prediction tools achieved acceptable diagnostic accuracy. The newly derived simple prediction tool offered potential ease of use.

Copyright © 2021. Published by Elsevier Inc.