Iron status in pregnant women: which measurements are valid?

Anaemia in pregnancy in developing countries continues to be a public healt h problem of significant proportion. At least 50% of the anaemia has been b lamed on iron deficiency In populations where chronic inflammation and iron deficiency anaemia coexist, the criteria to accurately define iron status are not always clear. Similarly in pregnancy with marked physiological chan ges, cut-off points for biochemical parameters need to be re-examined. In t his study rye examined the diagnostic accuracy of iron parameters including mean cellular volume (MCV), serum iron, transferrin, total iron binding ca pacity (TIBC) and its saturation, zinc protoporphyrin (ZPP), ferritin and s erum transferrin receptor (TfR) for the assessment of iron status in a popu lation of anaemic pregnant women in Malawi. Stained bone marrow aspirates w ere used as the standard for comparison, Results show that for the purpose of screening, serum ferritin is the best single indicator of storage iron provided a cut-off point of 30 mu g/l is u sed, A number of other commonly used parameters of iron status were shown t o have limited diagnostic accuracy. Logistic regression was used to obtain mathematical models for the prediction of bone marrow iron status using a c ombination of available parameters.