Serum levels of erythropoietin and soluble transferrin receptor during pregnancy in non-beta-thalassemic and beta-thalassemic women

Background and Objectives. In non-thalassaemic women serum erythropoietin ( Epo) level increases during pregnancy, whereas that of soluble transferrin receptor (STFR) drops slightly in the first two trimesters to attain the or iginal values in the third trimester. In this study the time-course of thes e two parameters was explored in beta-thalassemic and non-beta-thalassemic women, both pregnant and not. Design and Methods. Two hundred and fifty-seven women were studied: 64 non- beta-thalassemic, nonpregnant women made up the reference group, 89 were no n-beta-thalassemic pregnant women, and 104 were beta-thalassemic pregnant o r non-pregnant women. The full blood count, hemoglobin levels and iran stat us (serum iron and serum ferritin levels) were explored by traditional meth ods. Serum Epo and STFR revels were measured with standard commercial kits. Results. In non-beta-thalassemic women the mean nonpregnant Epo level (10.9 5+/-4.7 mU/mL) increased in the first trimester (17.12+/-5.18 mU/mL), was s tationary in the second, and increased again in the third (31.43+/-14.13 mU /mL). STFR mean value dropped in early pregnancy from 2.4+/-0.72 mg/L to 1. 78+/-0.64 mg/L, and then returned to the original value (2.38+/-0.94 mg/L). In beta-thalassemic women the mean non-pregnant Epo revel (15+/-6.56 mU/mL .) was higher than in non beta-thal non-pregnant women. During pregnancy it progressively increased to 35.60+/-25.46 mU/mL. STFR (non-pregnant level 3 .37+/-1.07 mg/L) gradually increased throughout the whole gestation period and by the third trimester its level was markedly higher than that in non-b eta-thal women at the corresponding stage of gestation (9.41+/-5.39 mg/L vs 2.38+/-0.94 mg/L). Interpretation and Conclusions. The STFR level changed to different extents in non-beta-thal and beta-thal women during their pregnancies. In the form er STFR markedly decreased in early pregnancy; in the latter it showed no d ecrease in the first trimester, increased in the second and reached very hi gh values in the third. This charge over time is likely to be the consequen ce of erythroid bone marrow hyperplasia and hyperactivity, which are usuall y present in all beta-thalassemic patients and in heterozygous carriers as well. (C) 2000, Ferrata Storti Foundation.