Prevention and Management of Iron Deficiency/Iron-Deficiency Anemia in Women: An Asian Expert Consensus

Abstract

The lack of standardized clinical practice impeding the optimal management of iron deficiency (ID) and iron deficiency anemia (IDA) in women is a global concern, particularly in the Asia-Pacific region. The aim of this study was to determine best practices through a Delphi consensus process. In Round 1, panelists were asked to rate their level of agreement with 99 statements across four domains: identification, diagnosis and assessment, prevention, and treatment of ID/IDA in women. In Round 2, panelists reappraised their ratings in view of the collective feedback and responses to Round 1. After two rounds, consensus (≥85% agreement) was reached for 84% of the Delphi statements. Experts agreed on the role of presenting symptoms and risk factors in prompting assessments of anemia and iron status in women. Experts repeatedly called for prevention, recommending preventive iron supplementation for pregnant women irrespective of anemia prevalence levels, and for non-pregnant adult women, adolescent girls, and perimenopausal women living in areas with a high prevalence of anemia. Experts unanimously agreed to prescribing oral ferrous iron as first-line therapy for uncomplicated ID/IDA. The recommendations and clinical pathway algorithms generated should be used to inform clinical practice and standardize the care of women at risk or presenting with ID/IDA in the Asia-Pacific region.

Variations in the Prevalence of Anemia of Varying Severity Among Urban Non-Pregnant Women — China, 2021

“…These findings suggest that women of reproductive age remain particularly vulnerable to anemia. The increased risk in women aged 40-49 may be attributed to menorrhagia common during the perimenopausal period, while the elevated risk in women aged ≥70 years could be related to the higher incidence of chronic diseases and inflammation accompanying aging (6,(8)(9)(10). Consistent with other research, our study confirmed regional variations in anemia prevalence.…”

The temporal trends of prevalence and years lived with disability of anaemia in China, Japan, and South Korea, from 1990 to 2021: Results from the Global Burden of Disease Study 2021

“…Delayed cord clamping until 1–3 minutes after birth is a simple, but effective intervention to reduce newborn anaemia by facilitating placental transfusion and iron-rich blood flow to the newborn [ 47 , 50 ], while routine iron supplementation is recommended for high-risk infants 6 to 12 months of age [ 51 ]. Moreover, preventive iron supplementation is recommended for all pregnant women, non-pregnant adult women, adolescent girls, and perimenopausal women with a high prevalence of anaemia [ 52 ]. A recent meta-analysis found that consuming condiments and seasonings fortified with iron plus other micronutrients may prevent anaemia in the general population [ 53 ].…”