7 - Addressing Anemia in Women: Proposals for Gender-Responsive Blood Draw Practices and Screening Protocols

Background:  Anemia affects one-third of women of childbearing age (World Health Organization. Anemia. WHO. https://www.who.int/health-topics/anaemia#tab=tab_1). Current research and clinical care blood draw guidelines fail to account for gender differences, representing a potential critical oversight in existing recommendations. Tailored healthcare interventions that consider gender are essential to address this major health concern.

Methods:  Our study assessed anemia prevalence and its impact on reproductive-age women globally. We conducted an exhaustive review of World Health Organization data and recent literature. We also evaluated existing blood draw practices and integrated insights from pivotal studies highlighting regional disparities and risk factors.

Conclusion:  Based on our review, we propose revising clinical and research blood draw protocols to include gender-specific considerations that reflect the high prevalence of often undiagnosed anemia in women. Additionally, guidelines for screening hematocrit (HCT) level checks for women of childbearing age should be considered for research protocols that collect blood samples from women to allow for the detection and management of occult anemia. This integrated approach would include developing tailored screening strategies for iron deficiency (ID) among women of childbearing age.

Limitations: No literature is available on the prevalence of anemia in research subjects in the US or globally or on the potential harm of “minimal risk” blood draws on study participants.
Anticipated challenges to this initiative include the need for consensus among health organizations on ID screening, variability in phlebotomy practices across institutions, and the adaptability of guidelines to the diverse needs of women of childbearing age.

Discussion:  This study underscores the need to revise clinical and research blood draw and ID guidelines to reflect gender differences and to address occult anemia and iron deficiency of potential research participants in studies with blood draws. These initiatives are aligned with WHO recommendations to enhance early detection and treatment of anemia in girls and women. Future work should focus on the prevalence of anemia in research subjects, outcomes and treatments.

Disclaimer: The authors are responsible for the views expressed which do not necessarily represent the views, decisions, or policies of their affiliated institutions. Institutions are listed for author identification only.