Authors
Walsh, ThomasO'Broin, Sean D
Cooley, Sharon
Donnelly, Jennifer
Kennedy, John
Harrison, Robert F
McMahon, Corinna
Geary, Michael
Affiliation
Rotunda Hospital, Dublin, Ireland.Issue Date
2012-02-01T10:37:56ZMeSH
AdolescentAdult
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
Metadata
Show full item recordCitation
Clin Chem Lab Med. 2011 Jul;49(7):1225-30. Epub 2011 May 31.Journal
Clinical chemistry and laboratory medicine : CCLM / FESCCDOI
10.1515/CCLM.2011.187PubMed ID
21627494Abstract
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
engISSN
1434-6621 (Print)1434-6621 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1515/CCLM.2011.187
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