Evaluation of Iron Deficiency Anemia in Pregnancy: Iron Deficiency Anemia in Pregnancy

Sadia Asghar; Saddiqa Azmat; Saima Rasheed; Muhammad Faisal Javaid; Rimsha Maqbool; Maria Anwar

doi:10.54393/pjhs.v5i09.2095

Authors

Sadia Asghar Department of Obstetrics and Gynaecology, Niazi Medical and Dental College, Sargodha, Pakistan
Saddiqa Azmat Department of Obstetrics and Gynaecology, Niazi Medical and Dental College, Sargodha, Pakistan
Saima Rasheed Department of Biochemistry, Watim Medical and Dental College, Rawalpindi, Pakistan
Muhammad Faisal Javaid Department of Biochemistry, Niazi Medical and Dental College, Sargodha, Pakistan
Rimsha Maqbool Department of Biochemistry, Niazi Medical and Dental College, Sargodha, Pakistan
Maria Anwar Department of Obstetrics and Gynaecology, Sahara Medical College, Narowal, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i09.2095

Keywords:

Anemia, Serum Ferritin, Total Iron-Binding Capacity, Transferrin Saturation, Maternal Health, Nutritional Deficiency, Pregnancy Complications

Abstract

Anemia in pregnancy was the common nutritional deficiency and a frequent medical concern that leads to numerous known complications, impacting both maternal and fetal health. Objective: To evaluate the biochemical parameters such as serum Iron, Ferritin TIBS and TfS in anemic and non-anemic pregnant women. Methods: In this cross-sectional study, pregnant women age 18-45 years attending the gynecological department of Niazi welfare foundation teaching hospital, Sargodha from April 2023 to January 2024 were included. Serum iron, ferritin, total iron-binding capacity, and transferrin saturation were assessed from blood samples. Independent sample t-test in SPSS version 26.0 was applied to see significant difference in biochemical parameters at value of <0.05. Results: Findings revealed mean hemoglobin level of 10.26 ± 1.52 g/dl in all participants. Anemic results were found in majority, accounting for 268 (70.9%) cases. Among these anemic patients, 149 (55.5%) had mild anemia, 107 (40%) had moderate anemia, and 12 (4.5%) had severe anemia. Anemic patients had significantly lower serum ferritin level (p = 0.02), serum iron (p < 0.001), and transferrin saturation (p < 0.002) than non-anemic patients. Additionally, total iron-binding capacity, (p < 0.001) indicated the anemic status of the pregnant women. Conclusions: Biochemical parameters of pregnant women with anemia were reduced compared to those without anemia. Healthcare providers should closely monitor pregnant women with reduced biochemical levels to prevent complications for both the mother and the fetus.

References

Georgieff MK. Iron deficiency in pregnancy. American Journal of Obstetrics and Gynecology. 2020 Oct; 223(4): 516-24. doi: 10.1016/j.ajog.2020.03.006.

Karami M, Chaleshgar M, Salari N, Akbari H, Mohammadi M. Global prevalence of anemia in pregnant women: a comprehensive systematic review and meta-analysis. Maternal and Child Health Journal. 2022 Jul; 26(7): 1473-87. doi: 10.1007/s10995-022-03450-1.

James AH. Iron deficiency anemia in pregnancy. Obstetrics & Gynecology. 2021 Oct; 138(4): 663-74. doi: 10.1097/AOG.0000000000004559.

World Health Organization. Guideline on haemoglobin cutoffs to define anaemia in individuals and populations. World Health Organization; 2024 Mar.

Obeagu EI, Adepoju OJ, Okafor CJ, Obeagu GU, Ibekwe AM, Okpala PU et al. Assessment of Haematological Changes in Pregnant Women of Ido, Ondo State, Nigeria. Journal of Research in Medical and Dental Science. 2021 Apr; 9(4): 145-8.

Wemakor A. Prevalence and determinants of anaemia in pregnant women receiving antenatal care at a tertiary referral hospital in Northern Ghana. BioMed Central Pregnancy and Childbirth. 2019 Dec; 19: 1-1. doi: 10.1186/s12884-019-2644-5.

Chibanda Y, Brookes M, Churchill D, Al-Hassi H. The ferritin, hepcidin and cytokines link in the diagnoses of iron deficiency anaemia during pregnancy: a review. International Journal of Molecular Sciences. 2023 Aug; 24(17): 13323. doi: 10.3390/ijms241713323.

Sharma S, Kaur SP, Lata G. Anemia in pregnancy is still a public health problem: A single center study with review of literature. Indian Journal of Hematology and Blood Transfusion. 2020 Jan; 36(1): 129-34. doi: 10.1007/s12288-019-01187-6.

Dangana A, Emeribe AU, Musa S, Moses LD, Ogar C, Ugwu C et al. Plasma Iron Indices in Pregnant Women Referred to the University of Abuja Teaching Hospital, Nigeria. International Journal of Medical Laboratory. 2020 Sep, 7(3): 168-178. doi: 10.18502/ijml.v7i3.4135.

Zhang Q, Lu XM, Zhang M, Yang CY, Lv SY, Li SF et al. Adverse effects of iron deficiency anemia on pregnancy outcome and offspring development and intervention of three iron supplements. Scientific Reports. 2021 Jan; 11(1): 1347. doi: 10.1038/s41598-020-79971-y.

Mahant H, Jain S, Patel A, Lapani B. Appropriate Method of TIBC Estimation in Reference to Serum Transferrin Levels. Journal of Laboratory Physicians. 2023 Mar; 15(01): 025-30. doi: 10.1055/s-0042-1750065.

Benson AE, Shatzel JJ, Ryan KS, Hedges MA, Martens K, Aslan JE et al. The incidence, complications, and treatment of iron deficiency in pregnancy. European Journal of Haematology. 2022 Dec; 109(6): 633-42. doi: 10.1111/ejh.13870.

Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron deficiency anemia in pregnancy: Novel approaches for an old problem. Oman Medical Journal. 2020 Sep; 35(5): e166. doi: 10.5001/omj.2020.108.

Ullah A, Sohaib M, Saeed F, Iqbal S. Prevalence of anemia and associated risk factors among pregnant women in Lahore, Pakistan. Women & Health. 2019 Jul; 59(6): 660-71. doi: 10.1080/03630242.2018.1544966.

Ray JG, Davidson AJ, Berger H, Dayan N, Park AL. Haemoglobin levels in early pregnancy and severe maternal morbidity: population‐based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2020 Aug; 127(9): 1154-64. doi: 10.1111/1471-0528.16216.

Okoroiwu IL, Chinedu-Madu JU, Obeagu EI, Vincent CC, Ochiabuto OM, Ibekwe AM et al. Evaluation of Iron Status, Haemoglobin and Protein Levels of Pregnant Women in Owerri Metropolis. Journal of Pharmaceutical Research International. 2021 Apr; 33(27A): 36-43. doi: 10.9734/jpri/2021/v33i27A31491.

Agarwal AM, Rets A. Laboratory approach to investigation of anemia in pregnancy. International Journal of Laboratory Hematology. 2021 Jul; 43: 65-70. doi: 10.1111/ijlh.13551.

Aloy-Amadi O, Akujobi AU, Nnodim J, Ndudim-Dike J, Edward A, Anokwute M. Serum Ferritin and iron/TIBC of pregnant women attending Nnamdi Azikiwe University teaching hospital, Nnewi, Anambra state, Nigeria: a longitudinal study. Clinical Obstetrics and Gynecology. 2020; 3(2).

Anwar Z, Abid Z, Ghazenfer T, Usman R, Naheed R, Kamal A et al. Biochemical and hematological profile of anemic and non-anemic pregnant women. Journal of the Dow University of Health Sciences. 2020 Aug; 14(2): 54-9. doi: 10.36570/jduhs.2020.2.995.

Obuchowska A, Standyło A, Obuchowska K, Gorczyca K, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. Iron deficiency anemia in pregnancy: evaluation and management. Journal of Education, Health and Sport. 2022 Aug; 12(9): 168-74. doi: 10.12775/JEHS.2022.12.09.021.

Raza N, Sarwar I, Munazza B, Ayub M, Suleman M. Assessment of iron deficiency in pregnant women by determining iron status. Journal of Ayub Medical College Abbottabad. 2011 Jun; 23(2): 36-40.

Bleyere MN, Bi AS, Kone M, Sawadogo D, Yapo PA. Iron Status and Red Cell Parameters in Pregnant and Non-pregnant Adolescents in Côte d'Ivoire (West Africa). 2014 Oct; 2(1): 8-22. doi: 10.9734/IBRR/2014/5112.