Iron deficiency in non-pregnant women with normal hemoglobin: a cross-sectional analysis of risk factors and clinical implications.

Background: Iron deficiency without anemia (IDWA) is a widespread but underdiagnosed condition in women of reproductive age. Traditional screening approaches that rely solely on hemoglobin levels may overlook significant iron depletion in seemingly healthy female patients, leading to missed opportunities for intervention against impaired cognition, reduced exercise capacity, and an increased risk of infection in this population. Objective: The objective of the study was to determine the prevalence of iron deficiency in non-pregnant women with normal hemoglobin levels and to identify the factors associated with iron deficiency. Methods: This cross-sectional study was conducted at an urban teaching hospital between March and August 2024. A total of 127 non-pregnant women aged 16-45 years were eligible; 100 women with hemoglobin levels ≥11 g/dL were enrolled using consecutive sampling (refusal rate: 21.3%, Results: Iron deficiency was identified in 41% (41/100) of the participants despite normal hemoglobin levels. A univariate analysis revealed significant associations between iron deficiency and a history of breastfeeding (crude OR = 9.13, 95% CI: 3.32-25.11, Conclusion: A substantial proportion of non-pregnant women with normal hemoglobin levels demonstrated biochemical evidence of iron deficiency. Breastfeeding history and a history of anemia were the strongest independent factors associated with iron deficiency. A comprehensive iron assessment, including ferritin and serum iron levels, is recommended for at-risk populations, particularly those with a history of breastfeeding or anemia.