Screening for Iron Deficiency among Pregnant Women

Abstract

Objective Iron deficiency (ID) and iron deficiency anemia (IDA) are extremely common in females in Saudi Arabia and are highly prevalent in pregnancy. The Saudi MOH Mother Health Passport recommends that pregnant women undergo testing for complete blood count and ferritin in every trimester. In this project, our goals were to describe practices of screening pregnant women for ID or IDA during pregnancy and to identify the prevalence of anemia and IDA in the study population, along with prescribed treatments. Methods In this retrospective study, all women who delivered in an academic tertiary care center from January to March 2022 were identified. From these, the study population included all patients who had at least 2 antenatal visits in the same center. Women with inflammatory conditions or inherited blood disorders were excluded. Data about gravidity and parity, results of testing of hemoglobin and iron profile, specially ferritin, were retrieved from health records. Records were also reviewed to identify patients who were prescribed iron (orally or intravenously) or received a blood transfusion. Results The study included 336 women. 591 (51.5%) hemoglobin tests were performed during pregnancy for the study sample, which represents a 50% gap in comparison with MOH recommendations of measuring Hb in every trimester. The overall prevalence of anemia was 28.6%, 12.2% in the first trimester, 37.2% in the second trimester, and 36.3% in the third trimester. Ferritin was measured in less than 5% of patients, and most women had ferritin levels below 15 ng/ml. Conclusions Screening practices for IDA and ID among pregnant women are suboptimal, and the prevalence of both entities is substantial. The development of detailed national guidelines for screening and managing ID and IDA in pregnancy is recommended.