Related Experiment Video
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.
Insights
This study establishes new hemoglobin thresholds for identifying anemia in Chinese infants aged 0-5 months. These findings are crucial for accurate diagnosis and timely intervention in infant populations.
Area of Science:
- Pediatrics
- Hematology
- Public Health Nutrition
Background:
- Anemia diagnosis in infants requires age-specific hemoglobin (Hb) reference values.
- Existing Hb thresholds may not accurately reflect the health status of infants in China.
- Establishing precise anemia thresholds is vital for early detection and management in pediatric populations.
Purpose of the Study:
- To develop age- and sex-specific hemoglobin percentiles and anemia thresholds for infants aged 0-5 months in China.
- To provide a robust reference for diagnosing anemia in this vulnerable demographic.
Main Methods:
- Utilized data from the National Nutrition and Health Systematic Survey (2019-2021) in China.
- Analyzed Hb levels in 2,155 "healthy" infants (0-5 months) using the HemoCue 201+ analyzer.
- Applied a generalized additive model to determine Hb distributions and the 5th percentile as the anemia threshold.
Main Results:
- Hemoglobin levels in infants peak at birth, decline to a nadir around 60 days, and then stabilize.
- Established specific Hb thresholds for anemia detection across different infant age groups (0-5 months).
- Anemia thresholds ranged from 92.8 g/L to 102.7 g/L, varying by month of age.
Conclusions:
- This study provides the first nationwide, population-based hemoglobin thresholds for defining anemia in Chinese infants aged 0-5 months.
- These established thresholds will aid clinicians and public health officials in the accurate diagnosis and management of anemia in infants.
- The findings support evidence-based strategies for improving infant nutritional status and health outcomes in 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.
