Serum Ferritin Dynamics In Maternal Anemia Management: Implications For Preterm Birth Risk

Abstract

Background: Preterm birth is one of the major factors that lead to neonatal morbidity and mortality, and maternal iron-deficiency anemia (IDA) has been described as a key but treatable risk factor. There is little evidence on the best approaches to management of IDA, particularly in the low- and middle-income countries (LMICs). Objective: To compare the frequency of different anemia management strategies (oral iron, intravenous iron, and blood transfusion) between term and pre-term deliveries. Method: The cross-sectional study was done at Ayub Medical Institute, Abbottabad, Pakistan, and involved 150 pregnant women with IDA. The data of the participants were examined to determine the frequency and the effectiveness of the anemia management strategies (blood transfusion, oral iron supplementation, and intravenous iron). The biomarker levels (the hemoglobin and serum ferritin) recorded at time of diagnosis were compared in term and preterm deliveries.  Results: The protective effect of oral iron supplementation on preterm birth was significant (OR = 0.09, 95% CI [0.04-0.21]; p < .001). Blood transfusion and intravenous iron did not portray any protective effect and appeared as indicative of more severe cases of anemia. The median serum ferritin and hemoglobin concentrations of preterm and term deliveries were also significantly lower in all of the treatment groups (p < .001). Moreover, a significant implementation gap was noticed because there was a substantial number of women who gave birth prematurely and who had no documented anemia treatment. Conclusion: Systematic early oral iron supplementation and routine ferritin screening are recommended as effective, contextually appropriate strategies to reduce preterm birth in populations with high anemia prevalence, such as Pakistan. Improved implementation and adherence strategies are critical to achieving these outcomes.

Keywords:  Preterm Birth, Serum Ferritin, Iron-Deficiency Anemia, Oral Iron Supplementation, Intravenous Iron Therapy, Blood Transfusion, Maternal Health, Pregnancy Outcomes, Low- And Middle-Income Countries.