Frequency and determinants of hypoferritinemia without anemia among reproductive age women in Lahore: A cross-sectional study.

Objective: To determine the frequency and determinants of Hypoferritinemia without anemia (HWA) among women of reproductive age in Lahore, Pakistan. Methodology: This cross-sectional study was conducted in four tertiary-care hospitals and their adjoining areas. Using simple random sampling, 1,347 women between the ages of 18-45 were selected. Patients from hospital OPDs who met the eligibility criteria and provided informed consent were selected to participate in the study. A structured questionnaire was filled out for each participant and blood samples were collected for CBC and serum ferritin evaluation. Results: HWA was present in 399 (29.6%) of the participants. Lethargy/feeling of tiredness was the most common symptom (90.7%). Regression analysis showed that rural residence (AOR = 3.04, p = 0.016), unemployment (AOR = 3.54, p = 0.004), use of medication (AOR = 15.02, p < 0.001), heavy menstrual bleeding: including duration >7 days (AOR = 7.49, p < 0.001), and use of > 2 pads/day (AOR = 3.21, p = 0.040), low meal frequency (<2/day) (AOR = 9.45, p < 0.001), breakfast skipping (AOR = 4.67, p = 0.029), and low dietary diversity (AOR = 3.29, p = 0.003) remained significant predictors of HWA. Conclusion: Hypoferritinemia without anemia was prevalent among participants, with lethargy as the primary symptom. Residing in a rural area, being unemployed, use of medication, prolonged menstrual days, and poor dietary intake all significantly raised the risk of HWA. These results show that vulnerable groups need more targeted nutritional education, reproductive health awareness, and better access to health care.