Evaluation of haemoglobin and serum ferritin level in preterm labour and preterm prelabour rupture of membrane (PPROM): a case-control study

ABSTRACT

Objective. Evaluate the level of maternal hemoglobin and ferritin in preterm labor and PPROM among Iraqi women.
Materials and Methods. The case-control study conducted at Azadi Teaching Hospital-Kirkuk included 225 pregnant women equally distributed into three groups, preterm, PPROM, and control group. A maternal blood sample (5 ml) was collected at the time of presentation, hemoglobin and ferritin measurements were performed for all participants.
Results. Hemoglobin showed a significantly low level among the preterm and PPROM groups compared to control group (p = 0.0001). While ferritin showed a significantly low level among the preterm group compared to other groups (p = 0.0001). Comparing preterm with control, a hemoglobin level of ≥ 10 was associated with 89% sensitivity and 44% specificity, and a ferritin level of ≥ 32 was associated with 84% sensitivity and 61% specificity. Comparing PPROM with control, a hemoglobin level of ≥ 10 was associated with 80% sensitivity and 46% specificity, and a ferritin level of ≥ 74 was associated with 80% sensitivity and 46% specificity. In logistic regression analysis for preterm and control groups, only Hb was found to be a significant independent risk factor for preterm. And for PPROM control groups, both Hb and ferritin level were found to be significant independent risk factors for PPROM.
Conclusions. Pregnant women with anemia and a lower ferritin level are at risk of preterm labour, while those with anemia and high level of ferritin are at risk of PPROM.