Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
ISSN
1437-4331
See all formats and pricing
More options …
Volume 49, Issue 7

Issues

Laboratory assessment of iron status in pregnancy

Thomas Walsh / Sean D. O'Broin / Sharon Cooley / Jennifer Donnelly / John Kennedy / Robert F. Harrison / Corinna McMahon / Michael Geary
Published Online: 2011-06-01 | DOI: https://doi.org/10.1515/CCLM.2011.187

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 μg/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 μg/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.

Keywords: iron status; pregnancy; serum ferritin; transferrin receptor

About the article

Corresponding author: Sean D. O'Broin, Department of Haematology, St James's Hospital, Dublin 8, Ireland Phone: +353-1-4162950


Received: 2010-10-07

Accepted: 2011-02-17

Published Online: 2011-06-01

Published in Print: 2011-07-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 49, Issue 7, Pages 1225–1230, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.187.

Export Citation

©2011 by Walter de Gruyter Berlin Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Uwe Gröber, Joachim Schmidt, and Klaus Kisters
Critical Reviews in Food Science and Nutrition, 2018, Page 1
[2]
Esther Calje
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2018, Volume 58, Number 6, Page E30
[3]
Josh M. Jorgensen, Per Ashorn, Ulla Ashorn, Lacey M. Baldiviez, Austrida Gondwe, Ken Maleta, Minyanga Nkhoma, and Kathryn G. Dewey
Maternal & Child Nutrition, 2018, Page e12640
[4]
Nuria Aranda, Carmen Hernández-Martínez, Victoria Arija, Blanca Ribot, and Josefa Canals
Public Health Nutrition, 2017, Volume 20, Number 8, Page 1405
[5]
Sean Lynch, Christine M Pfeiffer, Michael K Georgieff, Gary Brittenham, Susan Fairweather-Tait, Richard F Hurrell, Harry J McArdle, and Daniel J Raiten
The Journal of Nutrition, 2018, Volume 148, Number suppl_1, Page 1001S
[6]
Brietta M Oaks, Kevin D Laugero, Christine P Stewart, Seth Adu-Afarwuah, Anna Lartey, Per Ashorn, Stephen A Vosti, and Kathryn G Dewey
The Journal of Nutrition, 2016, Volume 146, Number 2, Page 343
[7]
Aaron Grossman
Review Journal of Autism and Developmental Disorders, 2017, Volume 4, Number 3, Page 205
[9]
Shristi Rawal, Stefanie N. Hinkle, Wei Bao, Yeyi Zhu, Jagteshwar Grewal, Paul S. Albert, Natalie L. Weir, Michael Y. Tsai, and Cuilin Zhang
Diabetologia, 2017, Volume 60, Number 2, Page 249
[10]
Seth Adu-Afarwuah, Anna Lartey, Harriet Okronipa, Per Ashorn, Mamane Zeilani, Lacey M. Baldiviez, Brietta M. Oaks, Stephen Vosti, and Kathryn G. Dewey
Maternal & Child Nutrition, 2017, Volume 13, Number 2, Page e12262
[11]
N. Ochsenbein-Kölble and R. Zimmermann
Der Gynäkologe, 2015, Volume 48, Number 10, Page 702
[12]
Blanca Ribot, Núria Aranda, Montserrat Giralt, Marta Romeu, Albert Balaguer, and Victoria Arija
Annals of Hematology, 2013, Volume 92, Number 2, Page 221
[13]
L Garcia-Valdes, C Campoy, H Hayes, J Florido, I Rusanova, M T Miranda, and H J McArdle
International Journal of Obesity, 2015, Volume 39, Number 4, Page 571
[14]
N. Aranda, B. Ribot, F. Viteri, P. Cavallé, and V. Arija
European Journal of Nutrition, 2013, Volume 52, Number 6, Page 1631
[15]
Chang Cao and Kimberly O O'Brien
Nutrition Reviews, 2013, Volume 71, Number 1, Page 35
[16]
Rinat Armony-Sivan, Jie Shao, Ming Li, Gengli Zhao, Zhengyan Zhao, Guobing Xu, Min Zhou, Jianying Zhan, Yang Bian, Chai Ji, Xing Li, Yaping Jiang, Zhixiang Zhang, Blair J. Richards, Twila Tardif, and Betsy Lozoff
Journal of Pregnancy, 2012, Volume 2012, Page 1
[17]
B. Ribot, N. Aranda, F. Viteri, C. Hernandez-Martinez, J. Canals, and V. Arija
Human Reproduction, 2012, Volume 27, Number 5, Page 1260
[18]
Jane Coad and Cathryn Conlon
Current Opinion in Clinical Nutrition and Metabolic Care, 2011, Volume 14, Number 6, Page 625

Comments (0)

Please log in or register to comment.
Log in