Hemoglobin and hepcidin have good validity and utility for diagnosing iron deficiency anemia among pregnant women.
Eur J Clin Nutr
; 74(5): 708-719, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-31624364
ABSTRACT
BACKGROUND/OBJECTIVES:
Screening and diagnosis of iron deficiency anemia (IDA) is cumbersome as it may require testing for hemoglobin, ferritin, and an inflammatory biomarker. The aim of this study was to compare the diagnostic capacity of hematologic biomarkers to detect IDA among pregnant women in Tanzania. SUBJECTS/METHODS:
We pooled data from an iron supplementation trial of 1500 iron-replete pregnant woman and a prospective cohort of 600 iron-deficient pregnant women. Receiver operating characteristic curves (ROC) for hematologic biomarkers were used to assess the sensitivity, specificity, and area under the curve (AUC) for iron deficiency (ID) and iron deficiency anemia (IDA), crude, or corrected for inflammation. Regression models assessed the relationship of baseline biomarker categories (gestational age <27 weeks) and IDA at delivery.RESULTS:
Hemoglobin had the largest AUC for crude ID (0.96), while hepcidin had the largest AUC for corrected ID (0.80). The optimal hepcidin cutoff for the diagnosis of corrected IDA based on maximal sensitivity and specificity was ≤1.6 µg/L. An hepcidin cutoff of <4.3 µg/L had a sensitivity of 95% for regression-corrected ID. Among iron-replete women who did not receive iron, the association of baseline hemoglobin >110 g/L with IDA at delivery (RR = 0.73; 95% CI 0.47, 1.13) was attenuated. Baseline hepcidin >1.6 µg/L was associated with reduced risk of anemia at delivery by 49% (95% CI 27%, 45%).CONCLUSIONS:
Ascertaining hemoglobin and hepcidin levels may improve the targeting of iron supplementation programs in resource-limited countries, though hepcidin's high costs may limit its use.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Complicaciones Hematológicas del Embarazo
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Hemoglobinas
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Anemia Ferropénica
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Mujeres Embarazadas
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Hepcidinas
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
País/Región como asunto:
Africa
Idioma:
En
Revista:
Eur J Clin Nutr
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos