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Obstet Gynecol Surv. 2015 May;70(5):342-53. doi: 10.1097/OGX.0000000000000172.

Iron deficiency anemia in women: a practical guide to detection, diagnosis, and treatment.

Author information

Chairman, Obstetrics & Gynecology, Mount Sinai Beth Israel Medical Center, and Clinical Professor of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY.
Chief of Anesthesiology, Critical Care Medicine and Hyperbaric Medicine, Englewood Hospital & Medical Center, Englewood, NJ, and Clinical Professor of Anesthesiology, Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
Director, Southern Colorado Maternal Fetal Medicine, Director Maternal Fetal Medicine Services St Francis Medical Center/Centura South State, Colorado Springs, and Visiting Associate Clinical Professor, Department of Obstetrics and Gynecology, University of Colorado, School of Medicine, Aurora, CO.
Associate Chief of Medicine, Erie County Medical Center, and Assistant Professor, Department of Medicine, State University of New York at Buffalo, Buffalo, NY.
Clinical Pharmacist, Ashton Medica, Mason, OH.
Vice President, Corporate Pharmacy, Barnabas Health, South Plainfield, NJ.
Director, Clinical Research, Lyndhurst OB/GYN Associates, Winston-Salem, NC.
Professor of Pathology & Medicine, Stanford University, Stanford, CA.



Iron deficiency anemia (IDA) remains a widely underdiagnosed and unappreciated women's health issue, affecting women of all ages. Despite the fact that IDA is easily diagnosed and treated, it continues to be a major public health issue. The World Health Organization estimates that 30% of nonpregnant and more than 42% of pregnant women have anemia.


A multidisciplinary Group for the Research and Education on Anemia Therapy in Women (GREAT Women II) was formed, sponsored by the Society for the Advancement of Blood Management. The goal was to focus attention on the impact of IDA on women at various stages of life and evaluate and use published literature to provide a simple, evidence-based approach to diagnose and treat IDA.


The group developed specific recommendations for evaluating and treating IDA in women. Initial diagnosis is defined as hemoglobin less than 12 g/dL in nonpregnant women. A trial of iron therapy (4 weeks) can be considered a first-line diagnostic tool. Alternatively, a low or normal mean corpuscular volume (<100 fL), low serum ferritin (<30 μg/L), and/or low transferrin saturation (transferrin saturation <20%) is sufficient to confirm IDA. If the patient does not fit the diagnosis of IDA or fails to respond to a trial of oral iron, or mean corpuscular volume is elevated, further diagnostic evaluation is needed, including iron studies, B12, folate levels, and renal function tests. If results are not definitive, and IDA persists, a hematology referral is recommended.


Clinicians should routinely identify and treat IDA, thereby decreasing its negative impact on health and quality of life of women.

[Indexed for MEDLINE]

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