Current Definition of Anemia in Women
Anemia in women is defined as a hemoglobin concentration below 12.0 g/dL in non-pregnant women, and below 11.0 g/dL during all trimesters of pregnancy and the postpartum period. 1, 2
Non-Pregnant Women
- The World Health Organization establishes the threshold for anemia in non-pregnant women at hemoglobin <12.0 g/dL 2
- This cutoff applies across all age groups, though some evidence suggests normal hemoglobin distribution varies with ethnicity and age 2
- In elderly women, some experts propose a lower threshold of <12 g/dL for both sexes, though this remains debated 2
Pregnant Women
The most recent international guidance recommends a uniform hemoglobin cutoff of <11.0 g/dL for diagnosing anemia across all trimesters of pregnancy and during the postpartum period. 1
Key Points on Pregnancy Thresholds:
- The FIGO 2025 recommendations advocate for a simplified, single cutoff of <11.0 g/dL throughout pregnancy, eliminating trimester-specific variations 1
- This differs from older guidance that used <11.0 g/dL in the first trimester but <10.5 g/dL in the second and third trimesters 3
- The uniform <11.0 g/dL threshold applies regardless of geographic setting or population 1
Important Caveats:
There is some divergence in the literature regarding second and third trimester cutoffs. While the most recent FIGO guidance uses <11.0 g/dL uniformly 1, ACOG has historically used <10.5 g/dL for the second and third trimesters 3. Given the priority on preventing maternal and perinatal morbidity and mortality, the more conservative <11.0 g/dL threshold across all trimesters is recommended, as anemia affects 32 million pregnant women globally and contributes to over 115,000 maternal deaths annually 1.