Work

Analysis of Pallor Examination for the Identification of Anemia Among Pregnant Women: A Scoping Review

Year: 2026

Type: article

Abstract: : Anemia affects more than 1.9 billion people globally, with pregnant women being among the most vulnerable. Pallor, a visible sign of reduced hemoglobin levels, is frequently used as a low-cost screening tool, particularly in resource-limited settings. This study aimed to assess the validity of clinical pallor signs for detecting anemia among pregnant women. A scoping review was conducted utilizing multiple databases, including PubMed, ScienceDirect, and Google Scholar. The review followed the PRISMA-ScR reporting guidelines and was systematically structured according to the PEO framework. Out of 812 articles identified, seven selected studies published between 2010 and 2025 were included in the review. The selected studies involved 1,847 participants from countries including India, Indonesia, Pakistan, Ethiopia, and Sri Lanka. This review found a significant association between physical pallor examination of the conjunctiva, buccal mucosa or tongue, and palms with anemia in both pregnant women and women of reproductive age ( p< 0.001) . This review reported that conjunctival, nailbed, tongue/buccal mucosa, palm pallor, and pallor at any site demonstrated a broad range sensitivity and specificity values ranging from above 0% to 100%. However, the combined pallor examination of the conjunctiva, buccal mucosa or tongue, nail beds, and palms tends to demonstrate high sensitivity and specificity (≥ 70%) in detecting anemia. Therefore, combined pallor assessment is recommended for future research. Nonetheless, further studies are needed to standardize examiner skills, lighting conditions, skin pigmentation considerations, pallor grading systems, and inter-rater reliability analysis. Pallor examination remains a useful initial screening method for detecting moderate to severe anemia in pregnant women in resource-limited settings. Keywords: anemia, pallor examination, diagnostic, validity, pregnant women

Source: International Journal of Women s Health

DOI: 10.2147/ijwh.s550863

Authors: Yuninda Ersianti, Susi Susanah, Gatot Winarno, Hadi Susiarno, Herry Herman, Sofie Krisnadi

Institutions: Padjadjaran University, Dr. Hasan Sadikin General Hospital

Language: English

Topic: Iron Metabolism and Disorders

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836