a From CDC.11 To avoid underdiagnosis of anemia at high altitude, add the appropriate value from this table to the cutoff value given in Table 1 or 2 in Tab 1, page 16.
Example: A woman living in Denver at an altitude of 5,280 ft and smoking 15 cigarettes per day would have a cutoff value for anemia of 11.8 g hemoglobin/dl during her first trimester:
11.3 + 0.5 for altitude.
If her hemoglobin were 11.5 g/dl at 11 weeks of gestation, she would be considered anemic.
Indications for Additional Testing
Serum Ferritin. Serum ferritin provides an estimate of iron reserves. Consider analysis of serum ferritin to confirm that an anemia is due to iron deficiency, especially if there has been inadequate or no hemoglobin or hematocrit response to iron supplementation.
Iron deficiency is the most common cause of anemia during pregnancy. To prevent iron deficiency anemia, routinely recommend iron supplementation at a low-dose, about 30 mg of elemental iron/day, for non-anemic pregnant women during the second and third