Abstract

Aim: Iron deficiency anemia (IDA) is an important public health problem in pregnancy, especially in developing countries. However, conventional markers for assessing iron status tend to be less reliable in pregnancy. Our aim was to study whether soluble serum transferrin receptor (sTfR) could be effectively used or not as a marker for iron deficiency in pregnancy. Methods: One-hundred and sixty-four relatively low- income healthy pregnant women, accepted for term delivery at Ege Gynecology and Obstetrics Hospital, were studied for iron status. The women with thalassemia trait, anemia of other causes, multiple pregnancies and a history of blood transfusion for any reason were excluded. One-hundred and thirty-two subjects were included in the study in the final analysis. Erythrocyte indices were studied with an automatic coulter (Symex SE, 9000). Serum ferritin and sTfR levels were measured by an immunoturbidimetric and nephelometric method (Dade Behring, Dutch) respectively. A serum ferritin level of less than 15 ng/dl was accepted as iron deficiency (ID). In addition to low ferritin level, a hemoglobin (Hb) level less than 11 g/dl were considered as IDA. The pregnant women uuith normal Hb and ferritin levels were evaluated as control group. The data were analyzed on SPSS for Windows (version 10.0). Chi square, Pearson correlation test and one-way ANOVA were used for statistical analysis. Results: The mean age and the gestational age of pregnant women were 26.4±4.7 years and 39.4±1 weeks, respectively. The median number of parity was 2. Seventy-two (52.3%) women had IDA and 15 (13.6 %) had ID. All of the hematological parameters showed statistical difference between the IDA, ID and the control groups, except MCHC (p<0.05). The levels of serum ferritin, sTfR and sTfR index showed statistically significant differences both in IDA and ID groups as compared to control group. Calculated sensitivity, specifity, positive and negative predictive values for sTfR (>1.8 mg/dl) were 70%, 72%, 83% and 55% respectively. Thirty percent of the subjects were not given iron supplementation during pregnancy, and 35% of them did not receive routine prenatal care. Conclusion: From the data in t his study, it can be said that because of the low sensitivity, the measurement of serum sTfR level for the evaluation of iron deficiency in the pregnancy does not provide additional benefit to the conventional serum ferritin measurement. Also, the pre valence of ID and IDA among pregnant women in low socio-economic population in Izmir is very high.