The role of haematological indices in predicting early iron deficiency among pregnant women in an urban area of Sri Lanka

• Published in: BMC blood disorders Vol. 18; no. 1; p. 37
• Main Authors: Rabindrakumar, Miruna Sudharshani Kalaimani, Pujitha Wickramasinghe, V, Gooneratne, Lallindra, Arambepola, Carukshi, Senanayake, Hemantha, Thoradeniya, Tharanga
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22.12.2018; BioMed Central
• Subjects: Anemia; Blood tests; Bone marrow; Brain research; Care and treatment; Diagnosis; Dietary supplements; Health aspects; Health care; Hematology; Hemoglobin; Iron; Iron deficiency diseases; Pregnancy; Pregnant women; Prenatal care; Prevalence studies (Epidemiology); Proteins; Risk factors; Urban areas; Womens health; Sri Lanka; Pregnancy; Red cell indices; Haemoglobin; Iron deficiency
• ISSN: 2052-1839; 2052-1839; 1471-2326
• DOI: 10.1186/s12878-018-0131-2

Early detection and treatment of iron deficiency during pregnancy is crucial for optimum pregnancy outcomes. Anaemia is a late indictor of iron deficiency measured as Hb < 11 g/dL, and is widely used as a proxy for iron deficiency. We aimed to evaluate the role of red cell indices as a screening tool for early detection of iron deficiency among pregnant women in an urban area of Sri Lanka. A cross-sectional study was conducted among 110 apparently healthy pregnant women ≤12 weeks of gestation attending antenatal clinics in Colombo, Sri Lanka. Women already on nutritional supplements were excluded. Full blood count, serum ferritin (SF) and high sensitive C-reactive protein (hs-CRP) assessments were performed. The women with evidence of inflammation as indicated by hs-CRP > 10 mg/L were excluded (  = 20) from data analysis. Anaemia (Hb < 11 g/dL) and iron deficiency (SF < 30 μg/L) were defined according to WHO guidelines. Receiver operating characteristics curves were used to derive red blood cell indices that showed the optimal cut-offs in detecting early iron deficiency. Of the 90 women, 63 (70.0%) were iron deficient (SF < 30 μg/L), out of whom 10 (15.9%) were identified as having iron deficiency anaemia (Hb < 11 g/dL). A high sensitivity (> 70%) in the prediction of iron deficiency was obtained for the optimal cut-off values of Hb < 12.2 g/dL, MCV < 83.2 fl, MCH < 26.9 pg and MCHC 33.2 g/dL while maintaining a specificity > 40%. Iron deficiency can be predicted in early stages using Hb and red cell indices, which is much less expensive. This could be a useful method in areas with limited resources and a high prevalence of iron deficiency.