Evaluation of Subclinical Anaemia Using Serum Ferritin Level in Rural Antenatal Mothers

Title: Evaluation of Subclinical Anaemia Using Serum Ferritin Level in Rural Antenatal Mothers

Authors: Preethi S P, Uma Mohanraj

DOI: http://dx.doi.org/10.18535/jmscr/v4i8.70

Abstract

Prevalence of anaemia in all the groups of women is higher in India as compared to other developing countries ^[1]; leading to maternal mortality, increase in Neonatal Intensive Care Unit (NICU) admission and under nutrition in childhood and adolescence. The aim of this study is to assess serum ferritin levels in non-anaemic (according to Haemoglobin concentration) mothers with Haemoglobin > 10g/dl and to express that Haemoglobin concentration of blood is inadequate to diagnose subclinical iron deficiency anaemia in rural antenatal mothers. Blood samples were collected from 200 antenatal women visiting Government Sivaganga Medical College and Hospital, Sivaganga, Tamil Nadu, India. Among them 56.5 % (n=113) prenatal women were in the 3^rd Trimester of pregnancy, 30 % (n=60) in the second Trimester and 13.5 % (n=27) in the first Trimester. Their mean age was 24.5 years, mean height was 153.9 cm. During clinical examination 9 women (4.5 %) were found to be clinically anaemic and the remaining 191 samples were classified according the range of Haemoglobin level. Of the 191 samples 48 samples (24%) containing Hb ≥ 10 g/dl (non anaemic) were taken for study of serum ferritin. The mean level of Ferritin decreases from first trimester to second to third trimester in the decreasing order of 40.8ng/ml, 36.4ng/ml and 27.6 ng/ml respectively. There is a positive correlation between Haemoglobin and Serum Ferritin in three different trimesters of antenatal women. On assessing Haemoglobin alone 76% of antenatal women under study were found to be anaemic. In non-anaemic women 16.7 % were found to be anaemic (iron deficiency anaemia) based on Serum ferritin level (less than 12 ng/ml). Totally 80% of antenatal women are found to be anaemic in this study area. Thus an increase of 4% detection rate and early diagnosis of anaemia is observed with Serum ferritin estimation.

Keywords: Serum Ferritin, Antenatal Women, Haemoglobin, Subclinical and Anaemia

References

1. DeMayer EM, Tegman A. Prevalence of anaemia in the World. World Health Organ Qlty. 1998; 38: 302-16.

2. Kalaivani, K. Prevalence and consequences of anaemia in pregnancy. Indian J Med Res. 2009; 627- 33.

3. Kaneshige, E. Serum ferritin as an assessment of iron stores and other hemat-ological parameters during pregnancy. Obstet. Gynaecol., 1981; 57: 238.

4. Paintin, D.B., Thomson, A.M. and Hytten, F.E. Iron and the haemoglobin level in pregnancy, J. Obstet. Gynaecol. Brit. Commonw., 1966; 73: 181.

5. Crinchton, R.R, (1973) The Biochemistry of Ferritin Br.J.Haematol, 26,677-681.

6. Peter, F. and Wang, S. Serum iron and total iron-binding capacity compared with serum ferritin in assessment of iron deficiency. Clin. Chem., 1981; 27:276. .

7. World Health Organization, Iron Deficiency Anaemia: Assessment, Prevention and Control. A guide for programme managers. 2001.

8. Anju Grewal. Anaemia and Pregnancy: Anaesthetic complication. Indian Journal of Anaesthesia, 2010.

9. Jacobs, A. and Wörwood, M. The clinical use of serum ferritin estimation. Br. J. Hematol, 1975; 31:1.

10. Socioeconomica – The Scientific Journal for Theory and Practice of Socio-economic Development 2015, 4(7): 167-174

11. (http://www.socscistatistics.com/tests/studentttest/Default2.aspx)

12. Van den Broek NR, Letsky EA. Etiology of anaemia in pregnancy in south Malawi. Am J ClinNutr 2000; 72:247S– 56S.

14. Puolakka J, Janne O, Pakarinen A, Vihko R. Serum ferritin as a measure of stores during and after normal pregnancy with and without iron supplements. Acta Obstet GynecolScand 1980; 95 (suppl):43–51.

15. Milman N J, Serum ferritin in Danes: studies of iron status from infancy to old age, during blood donation and pregnancy. Natl Med Assoc. 1983 Sep; 75(9): 885–889. PMCID: PMC2561499

16. Svanberg B, Arvidsson B, Norrby A, Rybo G, Solvell L. Absorption of supplemental iron during pregnancy—a longitudinal study with repeated bone-marrow studies and absorption measurements. Acta Obstet GynecolScandSuppl 1976; 48:87–108.

17. Jie Shao, Jingan Lou, Raghavendra Rao, Michael K. Georgieff, NikoKaciroti, Barbara T. Felt, Zheng-Yan Zhao, and Betsy Lozoff . Maternal Serum Ferritin Concentration Is Positively Associated with Newborn Iron Stores in Women with Low Ferritin Status in Late Pregnancy 1–3. J. Nutr., 2012; 142: 2004–2009.

18. O’Brien KO, Zavaleta N, Abrams SA, Caulfield LE. Maternal iron status influences iron transfer to the fetus during the third trimester of pregnancy. Am J ClinNutr. 2003; 77: 924–30.

19. Tamura, T., Goldenberg, R. L., Johnston, K. E., Cliver, S. P. & Hickey, C. A. (1996) Serum ferritin: a predictor of early spontaneous preterm delivery. Obstet. Gynecol. 87: 360–365.

20. Jenkins, D.T.M., Wishart, M.M. and Schenberg, C. Serum ferritin in pregnancy. Aust. NZ.J. Obstet. Gynaecol., 1978; 18: 223.

21. Dandekar, Ujjwala S., "Association between Serum Ferritin and Body Composition in Young Women" (2009). Masters Theses 1896 - February 2014. Paper 355. http://scholarworks.umass.edu/theses/355

22. Institute of Medicine, Food and Nutrition Board. Iron deficiency anaemia: guidelines for prevention, detection and management among U.S. children and women of child bearing age. Washington, DC: National Academy Press, 1993.

23. Hibbard BM. Controversies in therapeutics. Iron and folate supplements in pregnancy: supplementation is valuable only in selected patients. Br Med J 1988:297:1324–6.

24. Simmons WK, Cook JD, Bingham KC, et al. Evaluation of a gastric delivery system for iron supplementation in pregnancy. Am J ClinNutr 1993; 58: 622.

Corresponding Author

Preethi S P

Government Sivganga Medical College and Hospital

Sivaganga – 630 561, Tamil Nadu, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.