Serum transferrin receptors in detection of iron deficiency in pregnancy

Abstract

A prospective hospital-based study was conducted to evaluate the efficacy of serum transferrin receptors in the detection of iron deficiency in pregnant women. The iron status of 100 pregnant women with single uncomplicated term pregnancies in the first stage of labor was established using standard laboratory measures. These included complete hemogram, red cell indices, serum iron, percent transferrin saturation, and serum ferritin. In addition, serum transferrin receptor (STFR) was estimated. The results of 81 women with complete laboratory profiles were analyzed. Thirty-five (43.2%) women were anemic (hemoglobin <11 g/dl). Hemoglobin (Hb) showed a significant correlation with MCH, MCHC, serum iron, and percent transferrin saturation, suggesting that the anemia was likely to be due to iron deficiency. The mean STFR level was 18.05+/-9.9 mg/l in the anemic women and was significantly raised (p<0.001) compared with that of the nonanemic women. STFR correlated significantly with Hb (p<0.001), MCH (p<0.05), MCHC (p<0.01), serum iron (p<0.01), and percent transferrin saturation (p<0.01) and also showed a highly significant correlation with the degree of anemia. Serum ferritin in these women did not correlate with Hb, and only 54.4% of the women had levels <12 ng/ml, which does not reflect the true prevalence of iron deficiency. Serum transferrin receptor estimation is thus a useful measure for detecting iron deficiency in pregnancy.

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

“…These changes in erythropoietic activity are still well apparent after carefully excluding irondeficient women [126], parallel those in Epo production [122] and reticulocytes [126], and thus explain known alterations in the red cell mass throughout pregnancy. On the other hand, some studies have found that depletion of iron stores also produced a moderate elevation of sTfR over levels observed in non-iron-deficient pregnancies [122,127], particularly at time of labor [128]. Others have found that among anemic as well as among nonanemic pregnancies, sTfR values are not influenced by iron stores [82,124].…”

“…Others have found that among anemic as well as among nonanemic pregnancies, sTfR values are not influenced by iron stores [82,124]. Thus, elevated sTfR levels in late third trimester may help identify iron-deficient erythropoiesis with satisfactory specificity but low sensitivity, but reduced erythropoiesis limits the possibility of detecting iron deficiency in the rest of pregnancy [123,128,129].…”

Expression of ferritin receptor in placental microvilli membrane in pregnant women with different iron status at mid-term gestation

“…The grouping criteria are summarized in Table 1. Because multiple criteria are more sensitive and speci®c to de®ne iron de®ciency than any one single criterion (Rusia et al, 1999), in this study multiple criteria were used. Women were considered to have iron de®ciency anemia when, besides a hemoglobin (Hb) value of 110 gal (moderate anemia) or 90 gal (severe anemia), they also ful®lled two or more of the following independent indicators: serum iron 10.7 mmolal, total iron binding capacity (TIBC) !…”

Assessment and interpretation of micronutrient status during pregnancy

“…It is therefore most useful at the initial booking appointment since it can identify preexisting micronutrient deficiency that can be treated in time to prevent further deterioration (14)(15)(16) . During late pregnancy, however, it may fail to detect individuals with recently-developed deficiency brought about by the high demand for micronutrients (17,18) .…”