Abstract: Background: Ferritin is synthesized by a number of tissues, including the liver as a major site. Placental tissue makes a form of ferritin (Placental isoferritin), and levels of this isoferritin or ferritin(s) in circulation have been correlated with pregnancy outcome. Iron storage concentrations decrease with advancing gestation, hence the values of ferritin also decrease up to 32% in the first trimester, 39% in the second and even 53% during the third trimester. As far as there is no causal therapy of IUGR, the prediction of IUGR is one of the priority tasks of perinatal protection. The aim of this study is to evaluate the level of serum ferritin in pregnant women between 30 and 32 weeks of gestation & its value in the prediction of intra-uterine growth restriction.
Methods: This descriptive cross-sectional study was conducted at department of Obstetrics and Gynecology at Tanta university hospital & Elmenshawy Hospital in the period from August 2020 till December 2021. This study included 100 healthy pregnant women between 30 and 32 gestational weeks who were subjected to estimation of serum ferritin levels.
Results: The mean Gestational age by LMP was 30.94±0.802 weeks and the mean estimated fetal weight at 1st visit was 1240.90±168.691 gm. and resistance index (RI), the mean RI of UA was 0.60±0.119, the mean RI of MCA 0.54±0.083, as regard pusatility index (PI), the mean PI of UA was 1.0±0.256, the mean PI of MCA 1.33±0.425, and as regard systolic to diastolic duration ratio (S/D), the mean S/D of UA was 2.50±0.438, the mean S/D of MCA 2.99±0.622 and mean gestational age at delivery was 37.81±1.169 weeks, the mean Fetal weight at birth was 3059.20±623.356 gm and as regard APGAR score, the mean at 1 minute was 7.03±1.243, the mean at 5 minutes 8.80±1.206 and the mean Gestational age by LMP was 30.90±0.826 weeks, the mean BPD 7.48±0.190 cm, the mean FL was 5.90±0.173 cm, the mean AC was 25.17±2.509 cm, the mean AFI was 10.28±3.634 cm, the mean Estimated fetal weight at 1st visit (gm) was 1309.27±89.702 gm.
Conclusions: Maternal serum ferritin between 30 and 32 weeks of gestation were significantly higher in pregnancies destined to develop IUGR at a later gestational age than in normal. A cutoff of serum ferritin >15.25 ng/mL had an accuracy of 90% to predict IUGR with sensitivity of 83.3%, specificity of 91.4%, a PPV of 68.3% and NPV of 96.2%.
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