Utility of erythrocyte indices in identifying iron depletion in pregnancy

Iron deficiency anaemia in pregnancy is common and is a major cause of maternal and neonatal morbidity worldwide. Serum ferritin is the current gold standard test for identifying iron depletion, with a cut-off value of 30 µg/L. Recent studies in low- and middle-income countries have identified mean cell haemoglobin concentration as a surrogate marker for the prediction of iron depletion.

We studied values from 786 antenatal blood results from 2018 in Oxford, UK, and correlated the red cell indices with serum ferritin measurements.

Haemoglobin, mean cell volume, mean cell haemoglobin and mean cell haemoglobin concentration have low specificity and sensitivity for the identification of iron depletion.

We found that haemoglobin, mean cell volume, mean cell haemoglobin and mean cell haemoglobin concentration do not have sufficient predictive value in this population to be used as a screening test for non-anaemic iron depletion.