Revisiting WHO haemoglobin thresholds to define anaemia in clinical medicine and public health

Pasricha, Sant‐Rayn; Colman, Katherine; Centeno‐Tablante, Elizabeth; Garcı́a-Casal, Marı́a Nieves; Peña-Rosas, Juan Pablo

doi:10.1016/s2352-3026(18)30004-8

Cited by 86 publications

(81 citation statements)

References 7 publications

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“…Due to physiological expansion of plasma volume in pregnancy, especially in the second and third trimesters [ 17 ], setting different thresholds for defining anemia diagnosis in pregnancy seems to be plausible. However, the current hemoglobin concentrations thresholds during pregnancy derived from non-pregnant populations, and there was limited evidence to clarify the association between those thresholds and subsequently clinical outcomes [ 18 ]. Additionally, it was reported that racial disparities were not negligible in maternal hemoglobin concentrations and pregnancy outcomes [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey

Tan

et al. 2020

BMC Pregnancy Childbirth

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Background The current evidence about anemia and iron deficiency anemia (IDA) during pregnancy remains elusive in China. The purpose of this study is to investigate the prevalence of anemia and IDA and their risk factors in Chinese pregnant women. Methods A nationwide cross-sectional survey of pregnant women was conducted during their antenatal visits. Using a multi-stage sampling method, 24 hospitals from 16 provinces across China were selected. Structured questionnaires were administered to collect information from participants and to extract clinical data from electronic medical records. Mixed-effects logistic regression models were performed to determine the risk factors associated with anemia and IDA. Results In total, 12,403 pregnant women were enrolled, including 1018 (8.2%) at the first trimester, 3487 (28.1%) at the second, and 7898 (63.7%) at the third. Overall, 19.8% of women were diagnosed with anemia and 13.9% were diagnosed with IDA. The prevalence of anemia and IDA varied among regions and increased by gestational month, peaking at the eighth gestational month (24.0% for anemia and 17.8% for IDA). Pregnant women at advanced stage of gestation, non-local residents, multiple gestations, multiparity, pre-pregnancy underweight, and those experiencing severe nausea or vomiting during pregnancy, were associated with higher risks of anemia and IDA. Conclusions The prevalence of anemia and IDA during pregnancy are similar to those from developed countries and vary across regions in China.

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Section: Discussionmentioning

confidence: 99%

Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey

Tan

et al. 2020

BMC Pregnancy Childbirth

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“…The current Hb thresholds defining anaemia in pregnancy are based on historical normal values derived from non‐pregnant populations, which are not clearly linked to clinical outcomes and there is ongoing debate as to the applicability of these values (Pasricha et al , ). The WHO is reviewing the evidence relating to the Hb below which anaemia should be defined (WHO, ; Pasricha et al , ). Until then, the guideline group agreed that the existing thresholds, being Hb <110 g/l in the first trimester, <105 g/l after 12 weeks and <100 g/l immediately postpartum (Pavord et al , ) were most practical, but that further work is needed to validate them.…”

Section: Definition and Prevalence Of Iron Deficiency Anaemia In Pregmentioning

confidence: 99%

UK guidelines on the management of iron deficiency in pregnancy

Daru²,

et al. 2019

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“…The six categories were: physiology of anemia, hemoglobin cutoffs for different population groups, definition of anemia across clinical and environmental contexts, approaches to develop anemia cutoffs, laboratory and diagnostic considerations, and the use of WHO hemoglobin cutoffs guidelines. Based on the questions and research needs that scored highest by stakeholders, top ranked questions were identified …”

Section: Who Project To Review Hemoglobin Thresholds To Diagnose Anemiamentioning

confidence: 99%

Use and interpretation of hemoglobin concentrations for assessing anemia status in individuals and populations: results from a WHO technical meeting

Garcı́a-Casal

Pasricha

Sharma

et al. 2019

Annals of the New York Academy of Sciences

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Anemia is an important public health problem that negatively affects health of individuals and economic potential of populations. An accurate case definition is critical for understanding burden and epidemiology of anemia, for planning public health interventions, and for clinical investigation and treatment of patients. The current threshold hemoglobin concentrations for diagnosis of anemia were proposed in 1968 and based on studies predominantly of Caucasian adult populations in Europe and North America. The World Health Organization is undertaking a project to review global guidelines for anemia. We describe the process of obtaining input from technical experts, researchers, blood bank experts, policy makers, and program implementers to identify key information or knowledge gaps for anemia diagnosis. From this scoping exercise, six priority areas were identified on diverse topics related to the use and interpretation of hemoglobin concentrations to diagnose anemia in individuals and populations. A call for authors was conducted to produce background, review, and research papers across priority topics. This paper summarizes the first technical meeting, which included commissioned papers as well as case studies, describes key data gaps identified, and describes the next steps in the guideline development process to assess available evidence and define knowledge gaps to improve anemia characterization.

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Revisiting WHO haemoglobin thresholds to define anaemia in clinical medicine and public health

Cited by 86 publications

References 7 publications

Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey

Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey

UK guidelines on the management of iron deficiency in pregnancy

Use and interpretation of hemoglobin concentrations for assessing anemia status in individuals and populations: results from a WHO technical meeting

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