Iron status in anemic pregnant women

A descriptive study at a tertiary care center was carried out to assess the prevalence of iron status in anemic pregnant women and to determine the appropriate iron supplement.

Eligible subjects were pregnant women with a hemoglobin concentration <11 g/dL. Pregnant women who received antenatal vitamin and/or iron supplements before blood testing and women with an underlying chronic disease were excluded. Hemoglobinopathy was defined by hemoglobin typing other than HbA2A, percentage of HbA2 >4%, and HbF >1.1%. We diagnosed iron deficiency and iron depletion if their serum ferritin were <12 and 20 ng/mL, respectively, whereas anemia from undetermined causes was defined by hemoglobin typing, namely: A2A, HbA2 <4% and HbF <1.1%, and serum ferritin >20 ng/mL.

Among the 137 anemic pregnant women recruited, 67 (49.8%) had HbA2A, 47(34.3%) HbEA, 15 (10.9%) HbEE, 3 (2.2%) HbCSA2A, 2 (1.5%) HbCSEA, 1 (0.7%) HbCSA2A Bart's, 1 (0.7%) HbEA Bart's, and 1 (0.7%) beta-thalassemia. Among the 67 women with normal hemoglobin (HbA2A), 14 (20.9%) had iron deficiency, and 12 (17.9%) iron depletion. Among the 70 women with hemoglobinopathy, 6 (8.6%) had iron deficiency, and 10 (14.3%) iron depletion.

Anemic pregnant women with hemoglobinopathy could also be iron deficient so will need iron supplementation, as other pregnant women do, and some iron replacement therapy.