Anemia and Iron Deficiency Anemia in Saudi Arabia: A Systematic Review of Prevalence and Contributing Factors

Background: Iron deficiency anemia (IDA) is among the most prevalent nutritional disorders worldwide and a growing public health concern among women in Saudi Arabia. Available Saudi evidence remains fragmented, with single-center studies that vary by population, region, and diagnostic criteria. This review evaluated the prevalence of anemia in Saudi Arabia, assessed gender-related differences across the lifespan, and highlighted local determinants and prevention strategies relevant to women. Methods: Eight cross-sectional studies (26,412 participants) reporting anemia prevalence in Saudi individuals aged ≥13 with both-sex data were identified across five databases (2007-2024), excluding chronic-disease and under-13 studies. Quality was appraised with the JBI checklist, and because of substantial heterogeneity, findings were synthesized narratively by population group (SWiM guideline) rather than pooled. Results: Anemia was consistently more prevalent in women than men across all population groups and regions. Female prevalence ranged from about 18-22% in older and community adults to over 65% in female university students, whereas male prevalence ranged from none detected to 28% in a hospital-based sample. The lowest mean hemoglobin (10.4 g/dL) occurred in young women. Between study heterogeneity was considerable (I² > 99%) and persisted within sex subgroups, so findings were synthesized by population group rather than pooled into a single estimate. Conclusions: Anemia remains a significant public health challenge among women in Saudi Arabia, shaped by an interacting set of dietary, sociocultural, hereditary, and health-system determinants specific to the local context. Beyond confirming the female burden, this review consolidates fragmented national evidence, appraises its quality, and translates the findings into targeted recommendations: dietary counseling to address local inhibitors of iron absorption, screening during peak-risk periods, and integration with existing premarital screening and food-fortification infrastructure.