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Updated: May 10, 2026
A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Hemoglobin Thresholds for Defining Anemia among Healthy Infants Aged 0-5 Months in China: A Population-based Study
Shu Xia Wang1, Shan Jiang1, Xue Hong Pang1
1National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention. Key Laboratory of Public Nutrition and Health, National Health Commission of the People's Republic of China. Key Laboratory of Human Breast Milk Science, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Objective:
To develop hemoglobin (Hb) percentiles and thresholds for defining anemia among infants aged 0-5 months in China.
Methods:
The National Nutrition and Health Systematic Survey for children aged 0 -17 years in China, a nationwide cross-sectional study, was conducted between 2019 and 2021. Hb levels were measured in infants using the HemoCue 201+ analyzer. Age- and sex-specific Hb distributions were constructed for "healthy infants", defined as those with adequate iron reserves at birth, exclusive breastfeeding, normal weight-for-age Z-score and weight growth velocity, normal neuropsychological development, and absence of acute or chronic diseases. A generalized additive model for location, scale, and shape was applied to fit the Hb percentiles. The 5th percentile of the Hb distribution was defined as the threshold for anemia.
Results:
A total of 10,174 infants aged 0-5 months participated in the study, among whom 2,155 healthy infants were included in the analysis. Hb levels peaked at birth, gradually decreased to a nadir around 60 days after birth, and then rose to a plateau. The Hb thresholds defining anemia were 102.7 g/L, 96.3 g/L, 92.8 g/L, 95.4 g/L, 97.1 g/L, and 95.8 g/L for the 0-, 1-, 2-, 3-, 4-, and 5-month age groups, respectively.
Conclusion:
This study establishes hemoglobin thresholds for defining anemia in infants aged 0-5 months based on a nationwide, population-based dataset in China.
