Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study
Eshan U. Patel
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorJodie L. White
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorEvan M. Bloch
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorMary K. Grabowski
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorEric A. Gehrie
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorParvez M. Lokhandwala
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorPatricia A. R. Brunker
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
Search for more papers by this authorRuchika Goel
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
Search for more papers by this authorPaul M. Ness
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorCorresponding Author
Aaron A. R. Tobian
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Address reprint requests to: Aaron A. R. Tobian, MD, PhD, Department of Pathology, School of Medicine, Johns Hopkins University, Carnegie 437, 600 North Wolfe Street, Baltimore, MD 21287; e-mail: [email protected].Search for more papers by this authorEshan U. Patel
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorJodie L. White
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorEvan M. Bloch
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorMary K. Grabowski
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorEric A. Gehrie
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorParvez M. Lokhandwala
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorPatricia A. R. Brunker
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
Search for more papers by this authorRuchika Goel
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
Search for more papers by this authorPaul M. Ness
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorCorresponding Author
Aaron A. R. Tobian
Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Address reprint requests to: Aaron A. R. Tobian, MD, PhD, Department of Pathology, School of Medicine, Johns Hopkins University, Carnegie 437, 600 North Wolfe Street, Baltimore, MD 21287; e-mail: [email protected].Search for more papers by this authorThis study was supported in part by grants R01AI120938 and R01AI128779 from the National Institutes of Health (Dr. Tobian).
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institutes of Health, the US Centers for Disease Control and Prevention, or the Johns Hopkins University.
Abstract
BACKGROUND
Blood donation results in a loss of iron stores, which is particularly concerning for young female blood donors. This study examines the association of blood donation and iron deficiency among adolescent and adult females in the United States.
STUDY DESIGN AND METHODS
A cross-sectional analysis was performed using data from the 1999–2010 National Health and Nutrition Examination Survey (NHANES). Females who reported their blood donation history in the preceding year and had serum ferritin (SF) measurements were included. Analyses were weighted and stratified by adolescents (16–19 years; n = 2419) and adults (20–49 years; n = 7228). Adjusted prevalence ratios (aPRs) were estimated by multivariable Poisson regression. Standard errors were estimated by Taylor series linearization.
RESULTS
Geometric mean SF levels (ng/mL) were lower in blood donors compared to nondonors among adolescents (21.2 vs. 31.4; p < 0.001) and among adults (26.2 vs. 43.7; p < 0.001). The prevalence of absent iron stores (SF < 12 ng/mL) was higher in blood donors compared to nondonors among adolescents (22.6% vs. 12.2%; aPR = 2.03 [95% confidence interval (CI) = 1.45–2.85]) and among adults (18.3% vs. 9.8%; aPR = 2.06 [95% CI = 1.48–2.88]). Additionally, the prevalence of iron deficiency anemia (SF < 26 ng/mL and hemoglobin < 12.0 g/dL) was also higher in blood donors compared to nondonors among adolescents (9.5% vs. 6.1%; aPR = 2.10 [95% CI = 1.13–3.90]) and among adults (7.9% vs. 6.1%; aPR = 1.74 [95% CI = 1.06–2.85]). Similar results were observed in a sensitivity analysis restricted to adolescents aged 16 to 18 years.
CONCLUSIONS
Blood donation is associated with iron deficiency among adolescent and adult females in the United States. These national data call for further development and implementation of blood donation practices aimed toward mitigating iron deficiency.
CONFLICT OF INTEREST
The authors have disclosed no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| trf15179-sup-0001-Tables.pdfPDF document, 120.2 KB |
Table S1. Measurement of blood donor status in the past 12 months, NHANES, 1999–2010. Table S2. Comparison of participants that were included and excluded from the analytic study population based on missing data on blood donor status and/or serum ferritin, NHANES, 1999–2010 (n = 11,379). Table S3. Association of blood donation in the past 12 months and iron deficiency among adolescent and adult females in the United States after multiple imputation using chained equations for missing data, NHANES, 1999–2010. Table S4. Association of blood donation in the past 12 months and iron deficiency among adolescent and adult females in the United States, NHANES, 1999–2002. Serum ferritin was measured by the BioRad radiometric immunoassay. Table S5. Association of blood donation in the past 12 months and iron deficiency among adolescent and adult females in the United States, NHANES, 2005–2008. Serum ferritin was measured by the Roche/Hitachi nephelometric immunoassay. Table S6. Association of blood donation in the past 12 months and iron deficiency in 16- to 18-year-old females, NHANES 1999–2010. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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