Hemoglobin Concentration during Early Pregnancy as an Accurate Predictor of Anemia during Late Pregnancy

Abstract

It is undetermined which blood variables related to iron storage during the first trimester of pregnancy could efficiently predict anemia occurring during the third trimester. Red blood cell count (RBC), hemoglobin concentration, hematocrit, ferritin, iron, and total iron binding capacity (TIBC) were assessed longitudinally during the first, second, and third trimesters of 231 healthy Japanese women. None of the patients had anemia in the first trimester and none used iron supplementation before the second trimester blood test. Anemia was defined as hemoglobin (Hb) < 11 g/dL for the first trimester and Hb < 10.0 g/dL for the third trimester. Forty-seven (20%) women developed anemia in the third trimester. The first trimester RBC, Hb, hematocrit, and ferritin levels were significantly lower in women with third-trimester anemia than those without anemia. The first trimester hemoglobin level exhibited a greater area under the curve of the receiver operating characteristic curve for prediction of the third trimester anemia than other blood variables; the optimal cut-off (12.6 g/dL) of hemoglobin yielded a sensitivity of 83% (39/47). First trimester hemoglobin levels were significantly better predictors of anemia during the third trimester than the indices of iron storage, including serum iron, ferritin, and TIBC levels.

Prediction of Iron Deficiency Anemia in Third Trimester of Pregnancy Based on Data in the First Trimester: A Prospective Cohort Study in a High-Income Country

“…The prevalence of anemia increased dramatically during pregnancy to reach 21.9% at T3 despite iron supplementation at T1 of all women with IDA at T1. These results were expected in High-Income Countries [ 2 , 14 , 17 , 18 ].…”

“…Transferrin saturation (TfS) was not performed because we determined SF, which demonstrated better efficacy for diagnosing IDA in pregnancy [ 6 , 20 ]. Furthermore, the study of Noshiro et al [ 14 ] demonstrated that the sensitivity of TfS is only 17% in predicting anemia in the third trimester, which validated our choice a posteriori. We decided to devote the budget of the study to more original and less studied parameters, Hepc and STfR, with the calculation of the SF/STfR ratio.…”

“…Moreover, the cost of each of these biochemical parameters was higher than the determination of a blood count. Interestingly, in a recent study [ 14 ], Noshiro K et al found quite similar results. In their study conducted in Japan, first trimester Hb levels were significantly better predictors of anemia at T3 than the indices of iron metabolism, including SF, serum iron and transferrin saturation, with an optimal cut-off value of an Hb level at 12.6 g/dL at T1.…”

“…In their study conducted in Japan, first trimester Hb levels were significantly better predictors of anemia at T3 than the indices of iron metabolism, including SF, serum iron and transferrin saturation, with an optimal cut-off value of an Hb level at 12.6 g/dL at T1. Like Noshiro et al [ 14 ], we suggest that Hb, which can be measured economically, could be an important indicator in clinical practice for predicting anemia at T3.…”

A Non-Invasive Hemoglobin Detection Device Based on Multispectral Photoplethysmography

“…Blood is collected from a vein or capillary to test for hemoglobin, which can be inconvenient and painful and increase the risk of infection. Most anemic patients are pregnant women, children, or those recovering from major surgeries, as well as those with severe chronic diseases, who are immunocompromised, or who have coagulation disorders [ 3 , 4 , 5 , 6 ]. Frequent blood tests can also lead to poor compliance.…”