Frontiers in medicine · 2025
Hepcidin, ferroportin, and hemoglobin as predictors of iron deficiency anemia risk and perinatal outcomes in twin pregnancy.
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Zhong Yanling, Deng Lin, Xu Xingyan, Zhou Jinfu, Yan Jianying, Luo Jinying
Аннотация
OBJECTIVE: This study investigated iron-deficiency anemia (IDA), third-trimester hepcidin and ferroportin levels, and perinatal outcomes in twin pregnancies.
STUDY DESIGN: Pregnant women with twin gestations (n = 195) were enrolled and classified into an IDA group (n = 63; further subdivided into adverse and non-adverse perinatal-outcome subgroups) and a non-iron-deficiency anemia group (n = 132). Serum hepcidin and ferroportin were measured at ≥28 weeks of gestation. Analyses included multivariate logistic regression and receiver operating characteristic curve assessments.
RESULTS: The prevalence of IDA was 32.3%. Hepcidin showed positive correlations with red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Ferroportin showed negative correlations with these indices as well as with hepcidin. Adverse outcomes occurred in 84.1% of pregnancies complicated by iron-deficiency anemia. The combined decrease in hepcidin and hemoglobin levels, together with an increase in ferroportin concentrations, yielded an area under the curve of 0.940 for predicting adverse outcomes.
CONCLUSION: IDA is common in twin pregnancies and is strongly associated with unfavorable maternal-fetal outcomes. The combined measurement of hepcidin, ferroportin, and hemoglobin has diagnostic and predictive value in assessing iron-deficiency anemia in twin pregnancies.
STUDY DESIGN: Pregnant women with twin gestations (n = 195) were enrolled and classified into an IDA group (n = 63; further subdivided into adverse and non-adverse perinatal-outcome subgroups) and a non-iron-deficiency anemia group (n = 132). Serum hepcidin and ferroportin were measured at ≥28 weeks of gestation. Analyses included multivariate logistic regression and receiver operating characteristic curve assessments.
RESULTS: The prevalence of IDA was 32.3%. Hepcidin showed positive correlations with red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Ferroportin showed negative correlations with these indices as well as with hepcidin. Adverse outcomes occurred in 84.1% of pregnancies complicated by iron-deficiency anemia. The combined decrease in hepcidin and hemoglobin levels, together with an increase in ferroportin concentrations, yielded an area under the curve of 0.940 for predicting adverse outcomes.
CONCLUSION: IDA is common in twin pregnancies and is strongly associated with unfavorable maternal-fetal outcomes. The combined measurement of hepcidin, ferroportin, and hemoglobin has diagnostic and predictive value in assessing iron-deficiency anemia in twin pregnancies.