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FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH)

FIGO · 2025 · international

Source and licence

Authors
Akaninyene E Ubom, Ferdousi Begum, Diana Ramasauskaite et al.
Title
FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH)
Journal
International Journal of Gynaecology and Obstetrics, 2025
DOI
10.1002/ijgo.70529
Licence
CC BY 4.0
Changes
Verbatim excerpts; formatting adapted

Full text retrieved 2026-10-27 from Europe PMC · PMC12640178

Licence statement of the original publication

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.

Open the original publication →Full text on Europe PMC

Recommendations

We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.

Abstract

Anemia affects 32 million pregnant women globally, contributing annually to more than 115 000 maternal deaths and 591 000 perinatal deaths worldwide. Low‐ and middle‐income countries (LMICs) bear the highest burden of anemia in pregnancy, with nearly 50% of affected pregnant women. It is now 2025, which is WHO's target year for a 50% reduction in maternal anemia, and the global prevalence of anemia in pregnancy remains more than twice the target of 15%. This calls for a renewed global focus on optimal approaches for reducing the burden and complications of anemia in pregnancy. In this FIGO Childbirth and Postpartum Hemorrhage (PPH) Committee paper, current best evidence on anemia in pregnancy has been reviewed and synthesized, to make recommendations on screening, diagnosis, prevention, and treatment of anemia in pregnancy. We recommend that all pregnant women should be screened for anemia in pregnancy at booking and again at 28 weeks of pregnancy, with a full blood count (FBC), or packed cell volume/hemoglobin concentration in settings where FBC is not available. A hemoglobin concentration cutoff of less than 11 g/dL in all trimesters of pregnancy and during the postpartum period, as well as in all settings and populations, is recommended for the diagnosis of anemia in pregnancy. Routine iron and folic acid supplementation, either alone, or as components of multiple micronutrient supplements, is also recommended during pregnancy. We also made recommendations for malaria and anti‐helminthic chemoprophylaxis, hemoglobinopathy screening, iron, folate, and multiple micronutrient supplementation, and blood transfusion in pregnant women with hemoglobinopathies. Finally, the relationship between anemia and postpartum hemorrhage is highlighted.

Contents of the original publication

The section headings of the original.

  • SUMMARY OF FIGO RECOMMENDATIONS ON THE SCREENING, DIAGNOSIS, AND PREVENTION OF ANEMIA IN PREGNANCY
  • Screening and diagnosis of anemia in pregnancy
  • Iron supplementation and prevention of iron deficiency anemia in pregnancy
  • Treatment of iron deficiency anemia in pregnancy
  • Folic acid supplementation in pregnancy and pre‐pregnancy
  • Vitamin B12 supplementation in pregnancy
  • Multiple micronutrient supplementation in pregnancy
  • Malaria chemoprophylaxis in pregnancy
  • Anti‐helminthic prophylaxis in pregnancy
  • Screening for hemoglobinopathy in pregnancy
  • Folic acid supplementation in pregnant women with hemoglobinopathy
  • Iron supplementation in pregnant women with hemoglobinopathy
  • Multiple micronutrient supplementation in pregnant women with hemoglobinopathy
  • Blood transfusion in pregnant women with hemoglobinopathy
  • Malaria chemoprophylaxis in pregnant women with hemoglobinopathy
  • Anemia and postpartum hemorrhage (PPH)
  • GRADING OF EVIDENCE AND STRENGTH OF RECOMMENDATIONS
  • BACKGROUND: EPIDEMIOLOGY OF ANEMIA IN PREGNANCY
  • DEFINITION AND DIAGNOSIS OF ANEMIA IN PREGNANCY
  • CAUSES OF ANEMIA IN PREGNANCY
  • IRON DEFICIENCY ANEMIA
  • Iron requirements and absorption in pregnancy
  • Iron supplementation in pregnancy
  • Screening and diagnosis of iron deficiency anemia in pregnancy
  • Treatment of iron deficiency anemia in pregnancy
  • FOLATE DEFICIENCY IN PREGNANCY
  • Folic acid supplementation in pregnancy and pre‐pregnancy
  • VITAMIN B12 DEFICIENCY IN PREGNANCY
  • Vitamin B12 supplementation in pregnancy
  • MULTIPLE MICRONUTRIENT DEFICIENCY IN PREGNANCY
  • Multiple micronutrient supplementation in pregnancy
  • HEMOGLOBINOPATHY IN PREGNANCY
  • Folic acid supplementation in pregnant women with hemoglobinopathy
  • Iron supplementation in pregnant women with hemoglobinopathy
  • Blood transfusion in pregnant women with hemoglobinopathy
  • MALARIA IN PREGNANCY
  • Malaria chemoprophylaxis in pregnancy
  • Malaria chemoprophylaxis in pregnant women with hemoglobinopathy
  • HELMINTHIC INFESTATIONS AND ANTI‐HELMINTHIC PROPHYLAXIS IN PREGNANCY
  • ANEMIA AND PPH
  • CONCLUSIONS

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