Premium
Iron status determination in pregnancy using the Thomas plot
Author(s) -
Weyers R.,
Coetzee M. J.,
Nel M.
Publication year - 2016
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12448
Subject(s) - iron deficiency , ferritin , soluble transferrin receptor , erythropoiesis , medicine , transferrin receptor , transferrin , iron status , physiology , serum iron , pregnancy , anemia , reticulocyte , immunology , chemistry , biochemistry , biology , genetics , messenger rna , gene
Summary Introduction Physiological changes during pregnancy affect routine tests for iron deficiency. The reticulocyte haemoglobin equivalent ( RET ‐He) and serum‐soluble transferrin receptor ( sTfR ) assay are newer diagnostic parameters for the detection of iron deficiency, combined in the Thomas diagnostic plot. We used this plot to determine the iron status of pregnant women presenting for their first visit to an antenatal clinic in Bloemfontein, South Africa. Methods Routine laboratory tests (serum ferritin, full blood count and C‐reactive protein) and RET ‐He and sTfR were performed. The iron status was determined using the Thomas plot. Results For this study, 103 pregnant women were recruited. According to the Thomas plot, 72.8% of the participants had normal iron stores and erythropoiesis. Iron‐deficient erythropoiesis was detected in 12.6%. A third of participants were anaemic. Serum ferritin showed excellent sensitivity but poor specificity for detecting depleted iron stores. HIV status had no influence on the iron status of the participants. Conclusion Our findings reiterate that causes other than iron deficiency should be considered in anaemic individuals. When compared with the Thomas plot, a low serum ferritin is a sensitive but nonspecific indicator of iron deficiency. The Thomas plot may provide useful information to identify pregnant individuals in whom haematologic parameters indicate limited iron availability for erythropoiesis.