Iron Supplementation Research Articles

Iron-Skin Axis: Exploring the Interplay between Iron Homeostasis and Skin Disorders.

Bedtime problems and night wakings are common in children under six, particularly in China. The current study summarizes the core tenets of the"Chinese guideline for the treatment of bedtime problems and night wakings in children under 6 years of age (2023)", and discusses the associated challenges and suggestions for practices relevant to both domestic and international contexts. This review draws on literature from PubMed and Web of Science, published up to 2025, combined with evidence from the guide itself, as well as relevant consensus statements and expert recommendations. The guideline provides three strong recommendations, including behavioral intervention, early sleep hygiene education, and bedtime massage; four conditional recommendations under professional supervision, including separate sleeping arrangements, white noise, melatonin and iron supplementation; and three non-recommended interventions, including pacifier use, early complementary feeding, and daytime physical activity. Challenges in assessment and treatment involve the absence of standardized diagnostic criteria, reliance on subjective reports, multifactorial etiology with frequent comorbidities, and culturally embedded family sleep practices. Comprehensive evaluation requires integrating both subjective and objective measures while accounting for medical, behavioral, and environmental factors within cultural frameworks. Intervention should be individualized through shared decision-making with parents, combining modalities based on etiological profiling, with non-pharmacological strategies constituting first-line management. Effective management for bedtime problems and night wakings in young children requires standardized tools, and culturally adaptable, and family-centered interventions according to evidence-based guidelines. Strengthening professional training and parental education is crucial for guideline implementation and improved pediatric sleep health.

Key Points Hematologic disorders in neonates are distinct from those in older children due to the ongoing nature of erythropoiesis and hemostasis, as well as the unique developmental physiology of newborns.The diagnosis of most hematologic disorders is based on reference ranges for the newborn and must account for gestational and postnatal age, as variation in normal hematologic values is higher in the neonatal period than at any other time of life.Neonatal anemia can be caused by blood loss, hemolysis, or decreased red cell production. Physiological anemia of the full-term newborn occurs between 6 and 12 weeks after birth and is not a pathological state. Anemia of prematurity is common in preterm infants, often requiring iron supplementation. Alloimmune hemolytic disorders, such as RhD and ABO incompatibility, are leading causes of hemolysis in neonates.Polycythemia in neonates, caused by increased erythropoiesis or erythrocyte transfusion, can result in serious complications from increased blood viscosity and impaired microcirculation.Hemostatic disorders in newborns, whether inherited or acquired, can be challenging to diagnose, as many coagulation protein concentrations are age dependent. Thrombocytopenia and thromboembolic disorders are common in sick neonates and are more often acquired than inherited.Vitamin K deficiency bleeding (ie, hemorrhagic disease of the newborn) is a significant concern in neonates, particularly in those who do not receive prophylactic vitamin K at birth. Bleeding manifestations in the classic form occur 2 to 7 days after birth in exclusively breastfed infants and are common without prophylaxis.Thrombocytopenia in neonates may result from immune-mediated mechanisms (eg, neonatal alloimmune thrombocytopenia [NAIT]), placing neonates at risk for severe bleeding, including intracranial hemorrhage.Neutropenia in neonates is often linked to maternal immune conditions and infections and, less commonly, genetic disorders of production. The risk of sepsis is significantly increased, and severe cases may require treatment with granulocyte colony-stimulating factor (G-CSF).

Anaesthetic Considerations for Patient Blood Management in Cancer Surgery: A Narrative Review.

Background: The 2021 Indonesian Nutritional Status Survey (SGI) found that the prevalence of stunting in Indonesia was 24.4%, exceeding the global prevalence of 22.2%. The prevalence of stunting in Central Java Province in 2022 was 20.9%. The percentage of stunted toddlers in Surakarta City in 2022 was 1.87%, an increase compared to 1.39% in 2021. Based on 2018 data from the Surakarta Health Office, the highest incidence of stunting was found at the Sangkrah Community Health Center (Puskesmas), at 3.35%. Stunting in children is often caused by inadequate nutritional intake for preconception adolescents during the first 8,000 days of life. One sign of inadequate nutrition is anemia in adolescents. Anemia can be prevented by regularly taking iron supplements (TTD) from adolescence. Purpose: To evaluate iron supplement administration among adolescent girls in Surakarta City. Methods: This study used a mixed-methods design. The study population was junior high and high school students in the Sangkrah Community Health Center (Puskesmas) area. Participants were 150 female students selected using cluster sampling. The first stage involved hemoglobin (Hb) testing and measuring the girls' knowledge and adherence to iron supplement administration using a questionnaire. The second stage involved focus group discussions (FGDs) with health workers from the Surakarta City Health Office, teachers, and junior high and high school students. Quantitative data were analyzed using product-moment correlation, while qualitative data were analyzed using thematic analysis. Results: The human resources involved in the iron supplement administration program at this school complied with the Anemia Prevention and Control Guidelines. The iron supplement distribution program has been implemented by the Surakarta City Health Office since 2022. Iron supplement distribution is carried out by 2-4 individuals. Most respondents in this study were compliant with iron supplement administration (73.3%). There was a significant relationship between iron supplement adherence and hemoglobin levels, with a p-value of 0.0001. Conclusion: The iron supplement program for adolescent girls has been running well. Monitoring is conducted by the Sangkrah Community Health Center every three months, and the majority of girls are compliant with iron supplement consumption.

Maternal anemia during pregnancy is associated with poor growth during early childhood, but it remains unclear whether treatment using intravenous iron could enhance child growth. To evaluate whether intravenous ferric carboxymaltose (FCM) treatment for moderate to severe anemia during the second trimester of pregnancy enhances postnatal child growth compared with standard-of-care (SOC) oral iron. This was a prespecified secondary analysis of a randomized clinical trial (Randomized Controlled Trial of the Effect of Intravenous Iron on Anaemia in Malawian Pregnant Women [REVAMP]). In REVAMP, pregnant women with capillary hemoglobin between 5 and 10 g/dL were recruited in the Blantyre and Zomba districts of southern Malawi between November 2018 and March 2022 and randomized to FCM or SOC. Their infants were followed up over 12 months post partum. Data analysis was conducted between August 2024 and August 2025. Mothers were given intravenous FCM up to 1000 mg once on trial enrollment (intervention group) or SOC oral ferrous sulfate, 200 mg twice daily (approximately 120 mg elemental iron per day) (control group) from 13 to 26 weeks' gestation until delivery. Children received no intervention. Length-for-age z score (LAZ) at 12 months was the primary growth outcome; secondary outcomes included weight-for-age z scores (WAZ), weight-for-length z scores (WLZ), stunting (LAZ <-2), underweight (WAZ <-2), and wasting (WLZ <-2). Length and weight were measured at birth and at 1, 3, 6, 9, and 12 months post partum. The repeated measures were analyzed using mixed-effects models. A total of 738 infants were followed up for 12 months between March 2019 and October 2022. A total of 371 (193 [52.0%] male; mean [SD] gestational age at birth, 39.5 [1.9] weeks) were in the FCM group, and 367 (187 [51.2%] male; mean [SD] gestational age at birth, 39.4 [2.3] weeks) were in the SOC group. There was no evidence of a difference between FCM and SOC groups in mean LAZ (mean difference, -0.15 [95% CI, -0.37 to 0.08]), WAZ (mean difference, -0.02 [95% CI, -0.21 to 0.16]) or WLZ (mean difference, 0.02 [95% CI, -0.20 to 0.24]) at 12 months. Similarly, there was no difference in the proportion with stunting, underweight, or wasting at all time points. Stunting was more common in mothers younger than 20 years, less than 150 cm in height, and with no education or primary education only, although treatment effects showed no evidence of heterogeneity. In this secondary analysis of a randomized clinical trial in southern Malawi, intravenous FCM treatment for moderate to severe anemia during the second trimester of pregnancy was not associated with substantial benefits on infant growth compared with SOC. anzctr.org.au Identifier: ACTRN12618001268235.

ABSTRACT Iron deficiency anemia (IDA) is a common nutritional disorder in mammals, particularly affecting neonates and neonatal piglets. Parenteral iron supplementation is widely used but carries toxicity risks at high doses. Due to rapid growth and low iron stores at birth, piglets serve as an ideal model for investigating early life iron supplementation and its impact on gut health. In this study, neonatal piglets were assigned to three groups: control (CON, no iron supplementation), moderate‐dose (MI, two low doses), and high‐dose (HI, a single high dose), all administered via intramuscular iron dextran. We found that both iron supplementation protocols significantly increased hemoglobin levels ( p &lt; 0.01) and effectively alleviated IDA. However, the HI group exhibited significant adverse effects, including elevated aspartate aminotransferase (AST) ( p &lt; 0.01), suppressed anti‐inflammatory cytokines (IL‐10, p &lt; 0.01), and increased tissue iron accumulation, whereas the MI group showed no such adverse effects. Gut microbiota analysis revealed that the HI group disrupted the gut microbiota, with a greater impact on fungal diversity than bacterial diversity, as indicated by α‐diversity metrics ( p &lt; 0.05), and also altered the intestinal metabolite profiles. Protein–protein interaction network analysis identified key genera and metabolites, including Fusarium , Geotrichum , Parabacteroides , Candida , and cholest‐4‐en‐3‐one, associated with duodenal iron accumulation. This study demonstrates that although high‐dose parenteral iron effectively corrects IDA, it causes liver dysfunction, immune suppression, systemic iron overload, and altered gut microbiota. Our findings highlight the importance of appropriate iron dosing and reveal broader roles of trace elements in shaping gut microbiota.

ABSTRACTBackground and AimAnemia is marked by a reduction in red blood cells or hemoglobin levels, leading to impaired oxygen transport. It presents a significant global public health issue, associated with elevated morbidity and mortality, especially among pregnant women and children. Therefore, this study aimed to evaluate the determinants of anemia among pregnant women attending antenatal care (ANC) at selected public health hospitals in Southwest Ethiopia.MethodsA case‐control study, conducted from January 1 to February 30, 2023, included 374 pregnant women (91 with anemia and 283 without). Data were collected through interviewer‐administered structured questionnaires. SPSS Version 21 was used for data analysis, employing binary logistic regression to identify factors associated with anemia. The significance level was set at 0.05.ResultsAfter adjusting for confounding variables, the determinants of anemia among pregnant women were identified as lack of iron supplementation [AOR = 2.86, 95% CI (1.45, 3.85)], consumption of hot drinks after a meal [AOR = 1.63, 95% CI (1.03, 2.76)], history of malaria infection [AOR = 4.34, 95% CI (2.35, 7.72)], hookworm infection [AOR = 2.57, 95% CI (1.48, 4.46)], and short birth interval [AOR = 8.64, 95% CI (4.98, 17.6)].ConclusionThe main factors contributing to anemia among pregnant women include insufficient iron supplementation, consumption of hot drinks after meals, a history of malaria, hookworm infection, and short birth intervals. To reduce anemia prevalence, it is essential to ensure adequate iron supplementation, educate women on the impact of hot drinks after meals, implement malaria prevention and treatment, address hookworm infections through sanitation and deworming, and promote optimal birth spacing through family planning education.

Heart failure (HF) is a chronic and progressive condition associated with significant morbidity and mortality and reduced quality of life. Among the various comorbidities that exacerbate HF outcomes, iron deficiency (ID) is increasingly recognized as a modifiable risk factor that contributes to decreased exercise capacity, fatigue, and hospitalizations, even in the absence of anemia. Approximately 30-50% of patients with HF present with ID, highlighting the need for routine screening and targeted management. The objective of this review was to summarize the pathophysiological basis, diagnostic criteria, and clinical implications of ID in HF and to provide evidence-based recommendations for its treatment based on current guidelines and clinical trials. Key clinical trials such as FAIR-HF, CONFIRM-HF, and AFFIRM-AHF have demonstrated that intravenous iron supplementation, particularly with ferric carboxymaltose, improves functional status, symptoms, and quality of life in patients with HF and ID. These benefits are observed irrespective of the presence of anemia, and treatment is associated with a favorable safety profile. Current guidelines recommend routine screening for ID in patients with chronic HF and consideration of intravenous iron supplementation in symptomatic patients with confirmed deficiency. Oral iron has shown limited efficacy in this population. In conclusion, ID is a treatable and impactful comorbidity in HF. Early detection and appropriate intravenous iron therapy can significantly improve patient-centered outcomes and should be incorporated into standard HF management strategies.

Red blood cell deficiency during pregnancy reflects a natural biological process that occurs as the body supports fertilization and embryo development. Pregnant women often experience low hemoglobin levels, typically around 11% in the first and third trimesters, or about 10.5 grams in the second trimester. Iron deficiency anemia arises mainly from inadequate iron intake and poor compliance with iron supplement consumption. The level of adherence among pregnant women is strongly influenced by their understanding of anemia and awareness of possible side effects of supplementation. This study aims to analyze the relationship between pregnant women’s knowledge about anemia and their compliance in consuming iron supplements to prevent anemia, focusing on the South City Community Health Center area. The research used a quantitative analytical survey with a cross-sectional design, involving 83 postpartum women selected through purposive sampling. Data were gathered using questionnaires, and the relationship between knowledge and compliance was tested using frequency distribution and chi-square analysis. The results revealed a significant correlation (p-value = 0.000), indicating that higher maternal understanding of anemia is associated with better adherence to iron supplement consumption among pregnant women in the study area.

We describe four cases of iron extravasation injuries presenting to a dermatology clinic, where compression applied post-infusion appeared to reduce or prevent cutaneous siderosis. In each case, distinct patterns of hyperpigmentation were observed, with areas of compression from bandages or dressings showing reduced staining. Iron extravasation, a complication of intravenous iron therapy, can cause permanent cosmetic damage and distress. Current treatment options for reversing staining are limited, costly and require multiple sessions. This case series suggests that compression may be a simple, safe and effective measure to minimise cutaneous siderosis and improve patient outcomes.

Heart failure is the leading single cause of hospitalisation in Germany and places a heavy clinical and psychosocial burden on patients, families, and caregivers. Since 2021, evidence‑based management of heart failure with reduced ejection fraction (HFrEF) has centred on four pharmacological "pillars": β‑blockers, sacubitril/valsartan (or an ACE inhibitor), mineralocorticoid‑receptor antagonists, and sodium-glucose co‑transporter‑2 (SGLT‑2) inhibitors. While these agents improve survival and quality of life, they also predispose to adverse effects - most notably electrolyte disturbances. Hypo‑ or hyperkalaemia can precipitate malignant arrhythmias and therefore demands vigilant monitoring. Iron deficiency is equally prevalent in the heart‑failure population; randomised trials have primarily tested intravenous iron(III)‑carboxymaltose and iron(III)‑derisomaltose to correct this deficit. This review summarises the most recent epidemiological data for heart failure in Germany and Europe, outlines current guideline‑directed therapies, and highlights key treatment‑related complications clinicians must anticipate and manage.

BackgroundHypophosphatemia, defined as low serum phosphate levels, is a frequent yet underrecognized condition associated with significant morbidity. Its etiology ranges from chronic conditions such as osteomalacia to acute states such as refeeding syndrome. This review systematically summarizes evidence and guidelines for phosphate testing and supplementation in adults, aiming to support clinical decision-making.MethodsWe conducted a systematic review following the PRISMA guidelines. Searches of MEDLINE, Embase, the Cochrane Library, and Google Scholar from inception to September 2024 included reviews, guidelines, and consensus statements addressing phosphate measurement for hypophosphatemia and supplementation in adults outside intensive care settings. Eligibility criteria included English-language publications focused on diagnostic and therapeutic recommendations. Quality assessment was performed using the AGREE II tool, and data were synthesized across chronic and acute clinical contexts.ResultsThirty-three publications (11 guidelines, 19 reviews, and 3 consensus statements) were included, with high heterogeneity in the recommendations. Phosphate measurement to evaluate chronic hypophosphatemia is recommended for persistent musculoskeletal symptoms, osteoporosis evaluation, and rare conditions known to cause chronic hypophosphatemia, such as X-linked hypophosphatemia and tumor-induced osteomalacia. The post-kidney transplantation stage requires intensive early monitoring for hypophosphatemia. Recommendations for testing for drug-induced hypophosphatemia, such as with ferric carboxymaltose, vary. Phosphate measurement to evaluate acute hypophosphatemia is advised in high-risk settings: refeeding syndrome, hyperglycemic hyperosmolar syndrome, alcoholic ketoacidosis, worsening COPD or asthma exacerbations. Further potential indications for phosphate measurement include certain iron infusions, tenofovir treatment, immediate post-kidney transplantation, and intensive hemodialysis. Supplementation is indicated for severe or symptomatic cases, with oral therapy preferred for chronic conditions and intravenous routes for acute, severe hypophosphatemia.ConclusionsThe heterogeneity in the recommendations emphasizes the need for individualized approaches based on clinical context. While robust evidence supports testing and supplementation under select conditions, gaps remain regarding optimal dosing and monitoring protocols. Clinicians should consider phosphate testing in high-risk scenarios and follow evidence-based supplementation guidelines tailored to chronic and acute hypophosphatemia. Future research is needed to unify recommendations and address existing uncertainties.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04415-1.

Background: Bed bugs (Cimex lectularius) are blood-sucking insects widely distributed in temperate regions. While they are not known to be vectors of infectious diseases, their bites often cause dermatological symptoms, such as pruritus and rash. Rarely, chronic infestations may lead to systemic complications, including iron deficiency anaemia. Only a few case reports, most involving individuals with reduced activities of daily living (ADL) or social isolation, have described this association. Case report: We report herein the case of an 82-year-old woman in whom a chronic bed bug infestation caused severe iron deficiency anaemia without skin symptoms. She presented nearly complete dependence in her ADL. On admission, her haemoglobin level was 2.7 g/dl, and the other, laboratory findings indicated iron deficiency anaemia. Various examinations excluded malignancy, haematological disease, and other sources of blood loss. Numerous bed bugs were observed on her body and clothing. Following a blood transfusion, iron supplementation, and eradication of the infestation through repeated bathing, her haemoglobin level improved. Thereafter, the anaemia did not recur. She was later transferred to a special nursing home, as eradication of the insects in her home was not feasible. Conclusion: This case illustrates that elderly individuals whose living environment is chronically infested by bed bugs can experience severe iron deficiency anaemia even in the absence of bite marks on the skin. A careful, physical examination and inspection of clothing and the living environment are crucial for diagnosis. Clinicians should consider bed bug bites as a potential cause of unexplained anaemia, particularly in older patients with reduced ADL.

Anemia remains a major public-health challenge in India, particularly among tribal adolescents who face nutritional, social, and cultural disadvantages. This cross-sectional study assessed the prevalence and determinants of anemia among 200 adolescents (10–19 years) from a remote tribal area of the Peth region, Nashik District, Maharashtra. Hemoglobin levels were estimated using the cyanmethemoglobin method, and socio-dietary data were obtained through structured questionnaires. Results revealed that 68 % of girls and 54 % of boys were anemic, mostly of moderate severity. Inadequate dietary diversity, early menarche, poor sanitation, and limited healthcare access were key contributing factors. Compared with national data from NFHS-5 (2019–21), anemia prevalence in this tribal cohort was markedly higher. Gender-based disparities and cultural taboos restricting food intake during menstruation further worsened the problem. The findings underscore the need for targeted school-based iron supplementation, nutrition education, and culturally sensitive interventions. Addressing anemia in tribal adolescents is vital for improving health equity, educational outcomes, and future socioeconomic development.

Effects of iron replacement on electrocardiogram parameters in breath-holding spells patients with iron deficiency

Background and Objectives: This study aimed to comparatively investigate the impact of postoperative intravenous iron therapy (IVIT) as an add-on to preoperative IVIT on clinical outcomes in frail versus non-frail patients with iron-deficiency anemia (IDA) in the setting of elective cardiac surgery. Materials and Methods: This was a retrospective single-center study. The data was collected prospectively between January 2021 and November 2024. A total of 200 patients with IDA (100 frail and 100 propensity-score-matched non-frail patients) who received IVIT before and/or after elective cardiac surgery were included. Patients were divided into four equal groups including frail pre/post group (frail patients with preoperative plus postoperative IVIT), non-frail pre/post group (non-frail patients with preoperative plus postoperative IVIT), frail pre group (frail patients with preoperative IVIT) and non-frail pre group (non-frail patients with preoperative IVIT). Perioperative parameters, postoperative complications, and length of hospital stay (LOS) were recorded in each group. Postoperative follow-up parameters included change in hemoglobin levels and reticulocyte count from baseline (on operation day, postoperative day 1, day 7, 1st month and 3rd month) as well as the hospital readmission and mortality rates within 3 months after surgery. Results: Hemoglobin levels (10.6 ± 1.2 g/dL at baseline to 12.6 ± 1.4 g/dL at 1st month and 13.4 ± 1.4 g/dL at 3rd month, p = 0.01 and p = 0.02) and reticulocyte counts (0.035 ± 0.005 × 1012/L at baseline to 0.075 ± 0.005 × 1012/L at 1st month and 0.085 ± 0.005 × 1012/L at 3rd month, p = 0.004 and p = 0.002) were significantly improved from baseline only in the frail pre/post group. Conclusions: Postoperative IVIT demonstrated improved postoperative hemoglobin levels and reticulocyte counts, besides its potential in reducing perioperative transfusions, in the setting of elective cardiac surgery in frail patients with IDA.

International guidelines recommend intravenous (IV) iron replacement in patients with heart failure (HF) with reduced or mildly reduced ejection fraction (HFrEF or HFmrEF) and iron deficiency (ID). IV iron therapy remains underutilised despite growing evidence of its positive impact on hospitalisation rates, quality of life, and symptom control in HF. In this study, we aimed to explore the prevalence of ID and adherence to guideline-directed medical therapy (GDMT) for ID in HF patients. It was a retrospective observational study performed at a tertiary hospital in Oman. All HF patients admitted between March 2022 and February 2024 were included. ID was defined as serum ferritin less than 100 μg/L or serum ferritin 100-299 μg/L with transferrin saturation (TSAT) of less than 20%. Patients in intensive care units, pregnant women, and those with HF with preserved LVEF (HFpEF) were excluded. Only 26% (n=97) of 376 patients with HFrEF/HFmrEF were screened for ID, and about half of them (n=52) were found to be iron deficient. ID was tested more often in patients with anemia compared to those without anemia (33.9% vs. 10.7%, p < 0.001). IV iron in the form of iron carboxymaltose (FCM) was administered in 19% of ID patients, but only 15% received the recommended dose of 1000 mg FCM. There was no statistically significant difference in patient demographics or comorbidities between patients with or without ID. Among 376 HF patients screened for ID, almost half were iron deficient. However, the compliance rate of IV FCM therapy remained quite low. Low screening rates and limited adherence to GDMT underscore the need for standardized hospital protocols for the management of ID in HF patients.

Functional and Prognostic Implications of Different Iron Deficiency Definitions in Heart Failure: Insights From HEART-FID.

PurposeTo investigate the incidence and clinical characteristic of preoperative anemia and its impacts on perioperative outcomes in gynecological inpatients.Patients and MethodsWe retrospectively collected data from surgical patients admitted to the Department of Gynecology at Peking University People’s Hospital between April 2023 and January 2024. The data included demographic information, preoperative laboratory tests, diagnoses, surgery records, and hospitalization information. Preoperative anemia was defined as hemoglobin (Hb) concentration less than 120 g/L according to the last blood test before surgery. The primary outcomes of this study were perioperative complications, including infection, heart failure, thromboembolic events, intestinal obstruction, and transfer to the intensive care unit (ICU). Secondary outcomes included perioperative RBC transfusion, length of stay (LOS) and hospitalization costs. Outcomes were compared between the anemic group and non-anemic group, and logistic regression analyses were used to identify risk factors associated with the study outcomes.ResultsThis study included a total of 2,519 patients, and the incidence of preoperative anemia was 30.8%. Compared with the non-anemic group, those in anemic group had younger age (44 vs 47, P < 0.001) and lower body mass index (BMI) (23.2 vs 23.9, P < 0.001); however, higher incidences of perioperative RBC transfusion (10.7% vs 1.7%, P < 0.001) and complications (4.4% vs 0.9%, P < 0.001), higher hospitalization costs (14531 vs 13681, P = 0.044) and longer LOS (6 vs 5, P < 0.001). According to multivariate analyses, lower BMI (aOR = 0.893, P = 0.016), having comorbidity (aOR = 4.422, P < 0.001), preoperative anemia (aOR = 6.259, P < 0.001), gynecological malignancy (aOR = 4.376, P < 0.001), longer surgery duration (aOR = 1.010, P < 0.001) and increased blood loss (aOR = 1.002, P < 0.001) were associated with higher incidences of perioperative complications. Based on final surgical pathology, we divided surgical patients into gynecologic malignancy and non-malignancy groups. Similar results were obtained in both groups, preoperative anemia remained a facilitating factor of perioperative RBC transfusion and complication. Additionally, we investigated whether patient blood management (PBM) before surgery could improve perioperative outcomes. The results revealed that preoperative RBC transfusion was a protective factor against perioperative complication (aOR = 0.032, P = 0.017), while the relationship between iron supplementation and perioperative complication remained unclear (aOR = 0.628, P = 0.502).ConclusionPreoperative anemia was related to higher incidence of perioperative RBC transfusion and complication, and it increased hospitalization costs and prolonged LOS in gynecological inpatients. PBM before surgery could help improve perioperative outcomes. These findings emphasized the importance of early identification and active management of anemia, which might help reduce transfusion needs, minimize complications, and ultimately enhance gynecological inpatients’ outcomes.