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Study of changes in red blood cell indices and iron status during three trimesters of pregnancy

Shailesh Kumar, Namrata Dubey, Ruchir Khare.

Background: During pregnancy, the hemodynamic and iron requirement changes. Several tests are used to determine iron status and anemia such as hemoglobin, hematocrit or packed cell volume, mean corpuscular volume and mean corpuscular hemoglobin, red cell distribution width, percentage of hypochromic red cells, serum ferritin, and serum transferrin. This study was undertaken with intent to record changes in hematological profile along with transferrin and ferritin during pregnancy. The data obtained may be helpful in establishing reference range of all red blood cell indices along with serum ferritin and transferrin during pregnancy.

Objective: To study changes in red blood cell indices and iron status during three trimesters of pregnancy.

Materials and Methods: A longitudinal study was conducted on pregnant women reporting antenatal clinic in the first trimester. Data in each trimester of 57 women were collected. Birth weight of newborn delivered was recorded, and statistical analysis was done by paired t-test.

Result: Fifty-seven study subjects were divided according to the birth weight of delivered babies. Most of the parameters recorded were within the reference range across trimesters. Except for few, the changes in parameters were in accordance with expected physiological response in pregnancy. Significant drop in hemoglobin and significant rise in transferrin levels across all trimesters resulted in poor outcome of pregnancy.

Conclusion: This study suggests that serum transferrin level estimation in all trimesters along with hemoglobin can be advised to avoid possible poor outcome of pregnancy. This study provides additional baseline data for basic hematological parameters in pregnant women. This would benefit especially in the antenatal care and assessment of pregnant women.

Key words: Pregnancy, serum transferrin, serum ferritin, red cell indices, birth weight

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