Laboratory assessment of iron status in pregnancy.

Hdl Handle:
http://hdl.handle.net/10147/207719
Title:
Laboratory assessment of iron status in pregnancy.
Authors:
Walsh, Thomas; O'Broin, Sean D; Cooley, Sharon; Donnelly, Jennifer; Kennedy, John; Harrison, Robert F; McMahon, Corinna; Geary, Michael
Affiliation:
Rotunda Hospital, Dublin, Ireland.
Citation:
Clin Chem Lab Med. 2011 Jul;49(7):1225-30. Epub 2011 May 31.
Journal:
Clinical chemistry and laboratory medicine : CCLM / FESCC
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207719
DOI:
10.1515/CCLM.2011.187
PubMed ID:
21627494
Abstract:
BACKGROUND: Efforts to improve maternal nutrition during pregnancy prompted an observational study of the occurrence of maternal iron deficiency and its laboratory diagnosis in almost 500 pregnancies. METHODS: In this longitudinal study, the biochemical and haematological iron indices of women (n=492) attending a prenatal clinic in a Dublin maternity hospital were assessed at first booking (mean 15.9 weeks), and after 24 weeks, and 36 weeks of gestation. Full blood counts were measured. Serum ferritin (SF), zinc protoporphyrin (ZPP), and transferrin receptor (sTfR) concentrations were assayed and transferrin receptor index (sTfR-Index) was calculated. The occurrence of low values and their diagnostic values were considered. RESULTS: A high occurrence iron deficiency (ID) at first booking (SF<12 mug/L) had increased over six-fold by 24 weeks, and all biochemical iron indices reflected progressive iron depletion right up to term. The WHO recommended anaemia "cut-off" (Hb<110 g/L) was insensitive to biochemical iron deficiency at booking, missing over 90% of the low SF values (SF<12 mug/L) which were mostly associated with much higher Hb levels. CONCLUSIONS: This study stresses the importance of including a biochemical index of iron status in prenatal screening and supports SF as the best indicator of biochemical ID overall. sTfR was insensitive to iron deficiency in early pregnancy, whereas the sTfR-Index, as a ratio, has the potential to distinguish between ID and physiological anaemia, and may offer stability in the assessment of iron stores from early pregnancy to full term. A policy of early screening of both Hb and SF concentrations is recommended as the minimum requirement for surveillance of maternal iron status in pregnancy.
Language:
eng
MeSH:
Adolescent; Adult; Anemia, Iron-Deficiency/blood/diagnosis; Clinical Laboratory Techniques/*methods; Female; Humans; Iron/*blood/deficiency; Longitudinal Studies; Pregnancy; Pregnancy Complications/blood/diagnosis; Pregnancy Trimesters/blood; Young Adult
ISSN:
1434-6621 (Print); 1434-6621 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorWalsh, Thomasen_GB
dc.contributor.authorO'Broin, Sean Den_GB
dc.contributor.authorCooley, Sharonen_GB
dc.contributor.authorDonnelly, Jenniferen_GB
dc.contributor.authorKennedy, Johnen_GB
dc.contributor.authorHarrison, Robert Fen_GB
dc.contributor.authorMcMahon, Corinnaen_GB
dc.contributor.authorGeary, Michaelen_GB
dc.date.accessioned2012-02-01T10:37:56Z-
dc.date.available2012-02-01T10:37:56Z-
dc.date.issued2012-02-01T10:37:56Z-
dc.identifier.citationClin Chem Lab Med. 2011 Jul;49(7):1225-30. Epub 2011 May 31.en_GB
dc.identifier.issn1434-6621 (Print)en_GB
dc.identifier.issn1434-6621 (Linking)en_GB
dc.identifier.pmid21627494en_GB
dc.identifier.doi10.1515/CCLM.2011.187en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207719-
dc.description.abstractBACKGROUND: Efforts to improve maternal nutrition during pregnancy prompted an observational study of the occurrence of maternal iron deficiency and its laboratory diagnosis in almost 500 pregnancies. METHODS: In this longitudinal study, the biochemical and haematological iron indices of women (n=492) attending a prenatal clinic in a Dublin maternity hospital were assessed at first booking (mean 15.9 weeks), and after 24 weeks, and 36 weeks of gestation. Full blood counts were measured. Serum ferritin (SF), zinc protoporphyrin (ZPP), and transferrin receptor (sTfR) concentrations were assayed and transferrin receptor index (sTfR-Index) was calculated. The occurrence of low values and their diagnostic values were considered. RESULTS: A high occurrence iron deficiency (ID) at first booking (SF<12 mug/L) had increased over six-fold by 24 weeks, and all biochemical iron indices reflected progressive iron depletion right up to term. The WHO recommended anaemia "cut-off" (Hb<110 g/L) was insensitive to biochemical iron deficiency at booking, missing over 90% of the low SF values (SF<12 mug/L) which were mostly associated with much higher Hb levels. CONCLUSIONS: This study stresses the importance of including a biochemical index of iron status in prenatal screening and supports SF as the best indicator of biochemical ID overall. sTfR was insensitive to iron deficiency in early pregnancy, whereas the sTfR-Index, as a ratio, has the potential to distinguish between ID and physiological anaemia, and may offer stability in the assessment of iron stores from early pregnancy to full term. A policy of early screening of both Hb and SF concentrations is recommended as the minimum requirement for surveillance of maternal iron status in pregnancy.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnemia, Iron-Deficiency/blood/diagnosisen_GB
dc.subject.meshClinical Laboratory Techniques/*methodsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIron/*blood/deficiencyen_GB
dc.subject.meshLongitudinal Studiesen_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshPregnancy Complications/blood/diagnosisen_GB
dc.subject.meshPregnancy Trimesters/blooden_GB
dc.subject.meshYoung Adulten_GB
dc.titleLaboratory assessment of iron status in pregnancy.en_GB
dc.contributor.departmentRotunda Hospital, Dublin, Ireland.en_GB
dc.identifier.journalClinical chemistry and laboratory medicine : CCLM / FESCCen_GB
dc.description.provinceLeinster-

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