(P17-046-25) Post-pandemic Change in Anemia and Iron Deficiency Anemia Among Children, Adolescents, and Women of Reproductive Age

Objectives: To  analyze changes in anemia and iron deficiency anemia (IDA) before and after the COVID-19 pandemic, and evaluate the impact of inflammation adjustment methods on iron deficiency (ID) estimates among children and women of reproductive age using National Health and Nutrition Examination Survey (NHANES) 2015 - August 2023

Methods: Children 1-5y, adolescents 12-19y, and women 20-49y who participated in the NHANES 2015- August 2023 were included for these analyses. Participants were excluded if they were pregnant or lacked serum ferritin and c-reactive protein.  Serum ferritin was measured using electrochemiluminescence immunoassay. Serum high-sensitivity c-reactive protein (hsCRP) and α1-acid glycoprotein (AGP) were measured using near infrared particle immunoassay and immunoturbidimetric assay, respectively.  Serum ferritin was analyzed as unadjusted and adjusted using the BRINDA method for: hsCRP alone, AGP alone, and hsCRP & AGP combined. Hemoglobin was adjusted for smoking.  All analyses were adjusted for the sampling design and appropriate sample weights.

Results: The prevalence of anemia increased across all ages, rising from 2.5% to 5.1% in children, from 11.2% to 17.8% in adolescents, and from 11.7% to 15.5% in women. However, the trends in inflammation-adjusted ID varied. In children, ID prevalence increased from 0.3% to 1.9%, while in adolescents and women, ID initially increased and then declined. Among adolescents, the prevalence changed from 8.8% to 8.7%, while in women, it decreased from 8.5% to 7.4%. When adjusted for inflammation markers (AGP, CRP, and AGP + CRP), IDA prevalence remained stable or increased between 2015 and early 2020 but showed fluctuations between 2021 and 2023. In adolescents, IDA prevalence increased slightly from 8.7% to 8.8% in 2015–2016 and from 7.0% to 7.4% in 2021–2023, while in children, it declined from 2.0% to 1.9% in 2021.

Conclusions: The prevalence of anemia increased across all ages, with the greatest increases observed in adolescents and women. When adjusted for inflammation, IDA exhibited mixed trends, decreasing in children, increasing in women, and fluctuating in adolescents. These findings highlight the need for further research to understand the underlying causes and develop targeted interventions to address anemia and ID disparities.

Funding Sources: None