Serum ferritin and soluble transferrin receptor levels as reliable indicators of iron deficiency anemia in pregnant women during third trimester

Abstract

Iron deficiency anemia represents one of the most prevalent nutritional deficiencies affecting pregnant women worldwide, with significant implications for both maternal and fetal health outcomes. This research investigated the diagnostic reliability of serum ferritin and soluble transferrin receptor measurements as biomarkers for identifying iron deficiency anemia in pregnant women during their third trimester. A cross-sectional analytical research was conducted at the Obstetrics Department of Lyon Regional Medical Center between March 2022 and October 2023, enrolling 186 pregnant women in their third trimester. Blood samples were collected and analyzed for hemoglobin, serum ferritin, soluble transferrin receptor, and the sTfR/log ferritin index. Results demonstrated that serum ferritin levels below 15 ng/mL showed 89.3% sensitivity and 91.7% specificity for detecting iron deficiency. The soluble transferrin receptor exhibited even greater diagnostic accuracy with 93.6% sensitivity and 88.4% specificity at a cutoff value of 28.1 nmol/L. The combined sTfR/log ferritin index achieved the highest diagnostic performance with an area under the receiver operating characteristic curve of 0.967. These findings indicate that combining serum ferritin with soluble transferrin receptor measurements provides superior diagnostic accuracy compared to traditional hemoglobin-based screening alone, offering clinicians a more reliable approach for early detection and management of iron deficiency anemia during pregnancy.