Variation in Antenatal Anaemia Guidelines Across the NHS in the UK: A Descriptive Cross-Sectional Study.

Variation in Antenatal Anaemia Guidelines Across the NHS in the UK: A Descriptive Cross-Sectional Study. | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 21 July 2025 V1 Latest version Share on Variation in Antenatal Anaemia Guidelines Across the NHS in the UK: A Descriptive Cross-Sectional Study. Authors : Sarah Haynes 0009-0004-8605-6263 [email protected] , Islam Balboula , Peter Collins , William Parry-Smith , Haddy Fye , Amy Elsmore , Rachel Collis , Luc de Lloyd , David Churchill 0000-0003-0548-2953 , Sarah Bell , and Simon J. Stanworth Authors Info & Affiliations https://doi.org/10.22541/au.175309405.55474762/v1 355 views 183 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective: To evaluate the content and consistency of antenatal anaemia guidelines across NHS sites in the UK and compare them with national recommendations. Design: Descriptive cross-sectional study. Setting: NHS trusts/health boards providing maternity services across the UK. Population/Sample: Guidelines from 51 NHS sites: 16 from the PANDA trial, 36 from the OBS UK study, and 3 additional Welsh sites. Methods: Guidelines were obtained via email or public sources. Two independent reviewers used a structured tool to extract data on screening, diagnosis, treatment, and monitoring. Guideline alignment with 2019 BSH recommendations was assessed, and data were analysed descriptively in RStudio. Main Outcome Measures: Variation in recommendations for screening methods, diagnostic thresholds, oral and intravenous iron use, and post-treatment monitoring. Results: Forty-nine guidelines were included, representing ~33% of UK births. Screening and diagnostic thresholds were generally aligned with national guidance. Variation was observed in: (1) oral iron treatment (indications, dosing, duration); (2) criteria for initiating intravenous iron; and (3) timing, biomarkers, and definitions for monitoring. Ferritin thresholds, reassessment intervals, and response criteria were often missing or inconsistent with national guidance. Conclusions: This study identified consistent screening recommendations but substantial variation in treatment and monitoring, often diverging from national guidelines. These findings highlight the need to better understand local–national discrepancies and their implications for those who commission, develop, and implement clinical guidelines. Funding : This study received no specific funding; the PANDA (NIHR RP-PG-NIHR200869) and OBS UK (HSDR-NIHR152057) trials are funded by the NIHR. Keywords : antenatal, anaemia, iron deficiency, pregnancy, guidelines, NHS. Supplementary Material File (antenatal_anaemia_guidelines_bjog_submission.docx) Download 72.81 KB File (in text_tables and figures bjog submission.docx) Download 511.59 KB Information & Authors Information Version history V1 Version 1 21 July 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords antenatal care clinical guidelines general obstetrics haematology: anaemia health services research Authors Affiliations Sarah Haynes 0009-0004-8605-6263 [email protected] University of Oxford Nuffield Department of Women's & Reproductive Health View all articles by this author Islam Balboula Cardiff and Vale University Health Board View all articles by this author Peter Collins Cardiff University Cardiff Division of Infection and Immunity View all articles by this author William Parry-Smith Shrewsbury and Telford Hospital NHS Trust View all articles by this author Haddy Fye Patient and Public Involvement and Engagement Representative OBS-UK Trial View all articles by this author Amy Elsmore Shrewsbury and Telford Hospital NHS Trust View all articles by this author Rachel Collis Cardiff and Vale University Health Board View all articles by this author Luc de Lloyd Cardiff and Vale University Health Board View all articles by this author David Churchill 0000-0003-0548-2953 Royal Wolverhampton NHS Trust New Cross Hospital View all articles by this author Sarah Bell Cardiff and Vale University Health Board View all articles by this author Simon J. Stanworth NHS Blood and Transplant View all articles by this author Metrics & Citations Metrics Article Usage 355 views 183 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Sarah Haynes, Islam Balboula, Peter Collins, et al. Variation in Antenatal Anaemia Guidelines Across the NHS in the UK: A Descriptive Cross-Sectional Study.. Authorea . 21 July 2025. DOI: https://doi.org/10.22541/au.175309405.55474762/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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