MATERNAL SERUM FERRITIN LEVEL AT 30-32 WEEKS GESTATION AS A BIOMARKER FOR PREDICTION OF ASYMMETRICAL INTRAUTERINE GROWTH RESTRICTION
Ayman Ahmed Abd El-Hamid Shedid
Department of Obstetrics and Gynecology, Faculty of Medicine, Benha University
Background: Intrauterine growth restriction is associated with high incidence of perinatal mortality and serious long term morbidity. Ferritin is an iron storage protein and failure of serum ferritin level to decrease with advancing pregnancy points to impaired iron extraction by the feto-placental unit leading to asymmetric intrauterine growth restriction. Aim of the study: Evaluation of serum ferritin levels at 30-32 weeks gestation as a marker and a predictor of asymmetrical intrauterine growth restriction. Patients and Methods: Blood sample was taken from 145 high risk pregnancies at 30-32 weeks in the period from July 2014 to March 2015 for estimation of serum ferritin level by the enzyme linked fluorescent assay method. Data of 115 pregnancies were available at birth and included 85 cases appropriate weight for gestational age, 25 cases with asymmetric intrauterine growth restriction and 5 with cases symmetric intrauterine growth restriction. Serum ferritin levels were analyzed the mean ± SD, the Student t test, the χ2 test and the receiver operating characteristic curve were used .Results were considered significant at p value <0.05. Results: Serum ferritin level was significantly higher in the asymmetric intrauterine growth restriction group compared to the appropriate weight for gestational age group (18.95±8.32 vs 12.01±3.82), (p<0.001). A cut off value of serum ferritin 17.17 ng/dl was 80% sensitive, 88.2% specific, 66.7 and 93.8% positive and negative predictive values with 86.4% overall accuracy. Conclusion: Estimation of serum ferritin level at 30-32 weeks gestation in high risk pregnancy is a good biomarker which can be used with other investigations for prediction and diagnosis of asymmetric intrauterine growth restriction.