The Effect of Iron Therapy on Electrocardiography Parameters in Children with Iron Deficiency Anemia

Noor Mohammad  Noori; Ghasem Miri  Aliabad; Tahereh  Boryr; Leila  Teimouri; Sahar Safapour  Moghadam; Alireza  Teimour

doi:10.18502/ijpho.v15i4.19632

Noor Mohammad Noori Professor of Pediatric Cardiology, Children and Adolescents Health research center, Research Institute of cellular and Molecular Science in Infectious Diseases, Zahedan University of Medical Science's, Zahedan, Iran
Ghasem Miri Aliabad Professor of Pediatric Hematology and Oncologist, Pediatric ward, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Tahereh Boryr Instructor of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
Leila Teimouri Teacher, MSc in Sport Physiology, Education Department of Lamerd County, Fars Province, Iran
Sahar Safapour Moghadam Pediatric resident, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
Alireza Teimour Associate Professor of Demography, Children and Adolescents Health research center, Research Institute of cellular and Molecular Science in Infectious Diseases, Zahedan University of Medical Science's, Zahedan, Iran

DOI: https://doi.org/10.18502/ijpho.v15i4.19632

Keywords: Children, Electrocardiography, Iron Deficiency Anemia

Abstract

Background: Iron is essential for hemoglobin (Hb) production and the body's ability to transport oxygen. This study aimed to evaluate the impact of iron deficiency anemia (IDA) on electrocardiographic (ECG) parameters in children.

Materials and Methods: This pre–post interventional study was carried out at Ali Asghar Hospital in Zahedan and included children aged 5 to 18 years diagnosed with IDA. For each participant, hematologic markers Hb, ferritin, serum iron, and total iron-binding capacity (TIBC) were assessed. In addition, ECG indices, including P wave duration (PWd), QT interval dispersion (QTd), corrected QT interval (QTc), Tp-e interval, and Tp-e dispersion, were recorded both at baseline and after three months of iron therapy.

Results: A total of 45 children (mean age: 11.47 ± 4.00 years) participated in the study. After three months of treatment with 4–6 mg/kg/day of elemental iron, significant improvements were observed in several hematological and ECG parameters, including ferritin, serum iron, TIBC, P wave duration, P wave dispersion, QTc, QTc dispersion, Tp-e interval, Tp-e dispersion, and the Tp-e/QTc ratio (p < 0.001). In children with Hb levels between 10 and 11 g/dL, all ECG parameters improved significantly (p < 0.001), while those with Hb levels between 8 and 9 g/dL showed significant improvement in all parameters except the Tp-e/QTc ratio (p = 0.002). Among children with ferritin levels >10 ng/mL, all ECG parameters improved (p < 0.001), whereas in those with ferritin ≤10 ng/mL, all but QTc showed significant changes (p =0.002). Serum iron levels between 15 and 20 µg/dL were associated with improvements in all evaluated parameters (p = 0.002), while those with levels between 21 and 28 µg/dL demonstrated significant changes only in TIBC and P wave duration (p = 0.002).

Conclusion: The study concluded that the Iron supplementation positively impacts hematological and ECG parameters, supporting heart health in children.