Evaluation of cardiac strain parameters in pregnant women with and without iron deficiency anemia: a prospective case control study.

BACKGROUND

Iron deficiency anemia (IDA) is highly prevalent in pregnancy and may impair cardiovascular function. Strain echocardiography can detect subclinical myocardial dysfunction, yet data on strain alterations in pregnant women with IDA are limited.

METHODS

This prospective comparative study included 80 pregnant women in the second or third trimester: 40 with IDA and 40 without anemia. All participants underwent comprehensive echocardiographic evaluation, including left ventricular global longitudinal strain (LV GLS) and right ventricular strain parameters. Laboratory iron indices were also assessed.

RESULTS

LV GLS was significantly reduced in the IDA group compared with controls (- 17.46 ± 2.14% vs. -19.34 ± 2.74%, p = 0.001). Basal right ventricular free-wall strain was more negative in the IDA group (p = 0.032), and systolic pulmonary artery pressure was higher (p = 0.005). ROC analysis identified an LV GLS cut-off of - 20.55% for detecting subclinical cardiac dysfunction (AUC = 0.699, sensitivity = 90.0%, specificity = 70.0%). Iron indices showed significant correlations with multiple strain parameters.

CONCLUSIONS

IDA in pregnancy is associated with subclinical alterations in left and right ventricular strain despite preserved ejection fraction. Strain echocardiography may be a valuable tool for early detection of cardiac involvement in anemic pregnant women.