The Utility of Hypochromic Markers in the Detection of Latent Iron Deficiency in Women in their First Trimester of Pregnancy

Haliz Salman  Sulaiman; Firdous Hussein Ahmed; Nasir  Al-Allawi

doi:10.56056/amj.2024.301

Authors

Haliz Salman Sulaiman MBChB; Senior House Office, Department of Hematology, Azadi Teaching hospital, Duhok, Iraq
Firdous Hussein Ahmed MBChB; FIBMS; Hematology Specialist, Department of Hematology, Azadi Teaching Hospital, Duhok, Iraq
Nasir Al-Allawi MBChB, MSC, PhD, FRCPath; Professor of Hematology, Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq

DOI:

https://doi.org/10.56056/amj.2024.301

Keywords:

Latent Iron deficiency, Pregnancy, Red cell indices

Abstract

Background and Objectives: While iron deficiency anemia is a documented common problem in pregnancy, there is limited information on latent iron deficiency. Accordingly, we aimed to determine the frequency of the latter in the first trimester of pregnancy and assess the utility of new hypochromic markers in screening for it.

Methods: In this cross-sectional study, we recruited 100 pregnant women in their first trimester attending the Maternity Hospital in the period between January and March 2023. Inclusion criteria included hemoglobin >11.0 g/dl, and no iron supplements. Serum ferritin was used to classify patients into latent iron deficiency or iron replete state. While a hematology analyzer was used to determine the new hypochromic markers: namely %Hypo-He, Ret-He, % Hyper-He, RBC-He.

Results: The mean age of enrollees was 29.3 (SD 5.5) years and included 38% with latent iron deficiency (hemoglobin > 11 g/dl and S. ferritin ? 30 ng/ml). The latter group had significantly lower hemoglobin (P=0.03), and %Hypo-He (P<0.001) than iron replete women. While neither MCV, MCH, reticulocyte counts, Ret-He, or RBC-He were different. Furthermore, %Hypo-He was significantly negatively correlated with serum ferritin (P<0.001) and had a fair discriminating power between latent iron deficiency and iron replete status.

Conclusion: High prevalence of latent iron deficiency was documented among pregnant women in their first trimester; Furthermore, %Hypo-He was a better red cell index to screen for it. Because of its high frequency and anticipated impact on fetal and maternal health, routine screening for latent iron deficiency in pregnancy may be warranted.

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