Serial evaluation of iron stores in pregnant Nigerians with hemoglobin SS or SC

Iron status of nonpregnant and pregnant Nigerian patients with hemoglobin SS or SC were assessed using serial hematological parameters, measured by Coulter counter, and serial serum ferritin concentrations measured by radioimmunoassays. The median value of 393 micrograms/L (range, 175 to 900 micrograms/L) for serum ferritin in nonpregnant patients with Hb SS and SC was significantly higher than that found in nonpregnant patients with Hb AA (median, 89.8 micrograms/L; range, 13 to 250 micrograms/L). Apart from packed cell volume values, there were no other significant differences between patients with Hb SS or SC and Hb AA in the other parameters assessed: mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. In both the normal pregnant patients (Hb AA) and pregnant patients with Hb SS and SC the serum ferritin values decreased as pregnancy advanced to 28 weeks and rose gradually thereafter. At similar stages of gestation serum ferritin values were significantly higher in patients with Hb SS or SC than in those with Hb AA. Pregnancy seems to have induced a significant rise in mean corpuscular volume and mean corpuscular hemoglobin values in the patients with Hb SS or SC, especially in the third trimester, than in patients with Hb AA. The pattern of change in mean corpuscular hemoglobin concentration values was similar in both groups of patients. From the data obtained, it seems the iron status in the patients with Hb SS or SC was good, and pregnancy did not push the patients into an iron deficiency state. The use of prophylactic iron supplementation in pregnant patients with Hb SS or SC appears unjustified.