Anemia and Poor Iron Indices Are Associated With Susceptibility to Febrile Seizures in Children: A Systematic Review and Meta-analysis

J Child Neurol. 2023 Mar;38(3-4):186-197. doi: 10.1177/08830738231170333. Epub 2023 Apr 26.

Abstract

Introduction: Febrile seizures are the most common type of seizure in children under the age of 5, and a number of risk factors for this condition have been identified. Several studies have examined the connection between iron deficiency anemia and febrile seizures in children, with inconsistent results. As a result, the authors sought to determine the precise link between iron deficiency anemia and its indices (mean corpuscular volume, serum iron, total iron-binding capacity, and ferritin) in conjunction to febrile seizures. Methods: A systematic literature search from several databases (PubMed, Europe PMC, ScienceDirect) was conducted from database inception until November 30, 2022. Studies were eligible if they investigated the relationship of the iron deficiency anemia and the aforementioned indices with the likelihood of febrile seizures. Results: This meta-analysis comprised 20 case-control studies with a total of 3856 participants. Our study revealed that iron deficiency anemia, low mean corpuscular volume, low serum iron, high total iron-binding capacity, and low ferritin were associated with the incremental risk of developing febrile seizures, with the odds ratios ranging from 1.24 to 1.59. Moreover, diagnostic test accuracy meta-analysis indicated that low serum ferritin level had the highest overall area under the curve value amid other iron deficiency anemia indices regarding our outcomes of interest. Conclusion: This study suggest that iron deficiency anemia and poor iron indices are associated with increased risk of febrile seizures in children.

Keywords: febrile seizures; ferritin; iron deficiency anemia; iron indices‌; mean corpuscular volume.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anemia, Iron-Deficiency* / complications
  • Anemia, Iron-Deficiency* / epidemiology
  • Case-Control Studies
  • Child
  • Ferritins
  • Humans
  • Iron
  • Seizures, Febrile* / complications
  • Seizures, Febrile* / epidemiology

Substances

  • Iron
  • Ferritins