Iron Deficiency and Iron Storage Markers in Different Pregnancy Stages in Sudanese Women of Different Age

Abstract

Background: The aim of this study was to evaluate the ID and iron storage markers in pregnant women suffering from anemia during various trimesters attending Omdurman Maternity Hospital in Sudan. Methods and Results: This cross-sectional study included 205 pregnant women aged 15 to 45 in various trimesters who attended Omdurman Maternity Hospital (Sudan) between May 2022 and January 2023. All pregnant women were divided into two groups: the case group included 159 pregnant women with anemia, and the control group included 46 apparently healthy pregnant women. The blood test parameters were measured using a Sysmex XT-1800i Automated Hematology Analyzer (Japan). The levels of serum iron (SI) and total iron-binding capacity (TIBC) were measured using a Vitrous-350 Chemistry Analyzer (USA). The serum ferritin (SF) levels were measured by electrochemiluminescence immunoassay on the Cobas e411 analyzer (Roche). Among anemic pregnant women, 33(20.8%) were in the first trimester of pregnancy, 68(42.8%) in the second trimester, and 58(36.5%) in the third. In the case group, more than six deliveries were found in 50.3% of cases, compared to 23.9% in the control group (P=0.0015). The blood levels of Hb and SF were significantly lower in all trimesters in the case group than in the control group. The SI level showed a significantly low level only in the third trimester in the case group, compared to the control group (P<0.05). In the case group, TIBС levels increased from trimester to trimester, reaching maximum values in the third trimester, indicating a low iron level in the blood. In the case group, in the first trimester, the levels of Hb and ferritin did not differ between the age groups of 15-25 years and >26 years. However, in the second trimester, the SF level was statistically lower in the age group of >26 years than in the age group of 15-25 years (45.83±5.0 vs. 49.02±3.71 ng/mL, P=0.0038), but in the third trimester, there was the opposite (37.50±4.9 vs. 26.9±4.5ng/mL, P=0.000), which indicated a presence of IDA in the age subgroup of 15-25 years. Conclusion: Pregnant women are at high risk of developing or worsening ID. Every pregnant Sudanese woman should be screened for IDA.