At the time of writing, Maria Elena D. Jefferds, Zuguo Mei, Yaw Addo, Heather C. Hamner, Cria G. Perrine, Rafael Flores-Ayala, and Andrea J. Sharma were with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Christine M. Pfeiffer was with the Nutritional Biomarkers Branch, National Center for Environmental Health, CDC, Atlanta.
Am J Public Health. 2022 Oct;112(S8):S826-S835. doi: 10.2105/AJPH.2022.306998.
Iron deficiency and the more severe sequela, iron deficiency anemia, are public health problems associated with morbidity and mortality, particularly among pregnant women and younger children. The 1998 Centers for Disease Control and Prevention recommendations for prevention and control of iron deficiency in the United States is old and does not reflect recent evidence but is a foundational reference for many federal, clinical, and program guidelines. Surveillance data for iron deficiency are sparse at all levels, with critical gaps for pregnant women and younger children. Anemia, iron deficiency, and iron deficiency anemia are often conflated but should not be. Clinical guidelines for anemia, iron deficiency, and iron deficiency anemia give inconsistent recommendations, causing nonsystematic assessment of iron deficiency. Screening for iron deficiency typically relies on identifying anemia, despite anemia's low sensitivity for iron deficiency. In the National Health and Nutrition Examination Survey, more than 70% of iron deficiency is missed among pregnant women and children by relying on hemoglobin for iron deficiency screening. To improve assessment and diagnosis and strengthen surveillance, better and more complete data and updated foundational guidance on iron deficiency and anemia are needed that consider new evidence for measuring and interpreting laboratory results. (. 2022;112(S8):S826-S835. https://doi.org/10.2105/AJPH.2022.306998).
缺铁以及更为严重的缺铁性贫血后遗症是与发病率和死亡率相关的公共健康问题，尤其是在孕妇和幼儿中。1998 年美国疾病控制与预防中心关于预防和控制缺铁的建议已经过时，无法反映最新证据，但它是许多联邦、临床和项目指南的基础参考。各级缺铁的监测数据都很匮乏，孕妇和幼儿的数据存在严重空白。贫血、缺铁和缺铁性贫血经常被混淆，但它们不应被混淆。贫血、缺铁和缺铁性贫血的临床指南给出的建议并不一致，导致对缺铁的评估不系统。缺铁的筛查通常依赖于识别贫血，尽管贫血对缺铁的敏感性较低。在全国健康和营养调查中，仅依靠血红蛋白进行缺铁筛查，会导致孕妇和儿童中超过 70%的缺铁漏诊。为了改善评估和诊断，并加强监测，需要更好、更完整的数据以及关于缺铁和贫血的最新基础指导，以考虑衡量和解释实验室结果的新证据。（。2022；112（S8）：S826-S835。https://doi.org/10.2105/AJPH.2022.306998）。
