Role of Maternal Serum Ferritin in the Prediction of Asymmetric Intrauterine Growth Restriction
Salem, S., Ashoush, S., Bayoumi, H., Elsabaa, H. (2019). Role of Maternal Serum Ferritin in the Prediction of Asymmetric Intrauterine Growth Restriction. EKB Journal Management System, 9(3), 494-500. doi: 10.21608/ebwhj.2019.45494
Shaimaa M Salem; Sherif Ashoush; Hassan A Bayoumi; Haitham A. Elsabaa. "Role of Maternal Serum Ferritin in the Prediction of Asymmetric Intrauterine Growth Restriction". EKB Journal Management System, 9, 3, 2019, 494-500. doi: 10.21608/ebwhj.2019.45494
Salem, S., Ashoush, S., Bayoumi, H., Elsabaa, H. (2019). 'Role of Maternal Serum Ferritin in the Prediction of Asymmetric Intrauterine Growth Restriction', EKB Journal Management System, 9(3), pp. 494-500. doi: 10.21608/ebwhj.2019.45494
Salem, S., Ashoush, S., Bayoumi, H., Elsabaa, H. Role of Maternal Serum Ferritin in the Prediction of Asymmetric Intrauterine Growth Restriction. EKB Journal Management System, 2019; 9(3): 494-500. doi: 10.21608/ebwhj.2019.45494

Role of Maternal Serum Ferritin in the Prediction of Asymmetric Intrauterine Growth Restriction

Evidence Based Women's Health Journal
Article 4, Volume 9, Issue 3, August 2019, Page 494-500  XML PDF (372.63 K)
Document Type: Original Article
DOI: 10.21608/ebwhj.2019.45494
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Authors
Shaimaa M Salem1; Sherif Ashoush email 2; Hassan A Bayoumi3; Haitham A. Elsabaa3
1Department of Obstetrics and Gynecology, Damietta Specialized Hospital, Damietta
2Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
3Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
Abstract
Aim: Asymmetric intrauterine growth restriction (IUGR) carries increased intrauterine and neonatal risks. Since most cases are idiopathic, identifying a predictive test remains an ideal prevention management. Maternal serum ferritin level is a potential predictor of later developing asymmetric IUGR.  Patients and Methods: Blood samples were drawn, at 30-32 gestational weeks, from 450 women who were then followed-up resulting in 32 term pregnancies with asymmetric IUGR. The control group included the first recruited 32 women delivering adequate for gestational age neonates at term. Serum ferritin was then measured in the stored serum samples.  Ultrasound scanning was performed at 30-32 weeks then at 37 weeks. Umbilical and middle cerebral artery Doppler scans were added at 37 weeks.  Results: Serum ferritin, at 30-32 weeks, was higher in women delivering IUGR babies (19.3±6.83 vs 14±5.18, p<0.01). At 37 weeks, pregnancies with asymmetric IUGR had significantly (p<0.01) higher umbilical artery resistance and pulsatility indices (0.71±0.06 vs 0.59±0.07 and 1.24±0.17 vs 0.86±0.09, respectively). Their middle cerebral artery RI and PI were significantly (p<0.01) lower than controls (0.74±0.09 vs 0.81±0.05 and 1.64±0.07 vs 1.9±0.15, respectively). Ferritin level correlated significantly with neonatal birthweight. A cutoff level >18.2 ng/mL had a sensitivity of 59.4% and a specificity of 90.6%. The area under curve showed an accuracy of 76.8%. Women with ferritin >18.2 ng/ml were 10.23 times more likely to get asymmetrically growth restricted neonates (CI 2.89–36.17, p<0.001).  Conclusion: This study presents further evidence that maternal serum ferritin may be a useful test in the prediction of asymmetric IUGR.
Keywords
intrauterine growth restriction; Doppler; ferritin; neonatal birthweight; small for gestational age
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