Utility of erythrocyte indices in identifying iron depletion in pregnancy.

BACKGROUND: Iron deficiency anaemia in pregnancy is common and is a major cause of maternal and neonatal morbidity worldwide. Serum ferritin is the current gold standard test for identifying iron depletion, with a cut-off value of 30 µg/L. Recent studies in low- and middle-income countries have identified mean cell haemoglobin concentration as a surrogate marker for the prediction of iron depletion.

METHODS: We studied values from 786 antenatal blood results from 2018 in Oxford, UK, and correlated the red cell indices with serum ferritin measurements.

RESULTS: Haemoglobin, mean cell volume, mean cell haemoglobin and mean cell haemoglobin concentration have low specificity and sensitivity for the identification of iron depletion.

CONCLUSIONS: We found that haemoglobin, mean cell volume, mean cell haemoglobin and mean cell haemoglobin concentration do not have sufficient predictive value in this population to be used as a screening test for non-anaemic iron depletion.