Evaluation of Anemia in Obese Pregnant Mothers Using Transferrin Receptor Index (TRI) and Hepcidin and Finding its Relation to Iron Stores of the Newborn

Aim: The study aimed to analyze the cause of anemia associated with pre-pregnancy maternal obesity and to clarify relationship between obesity, inflammation and anemia and identify their effect on newborns iron stores.Patients and Methods: The study was conducted on (39) full term pregnant women, randomly selected from Al-Zahraa hospital. Categorized to; Group 1 (17) obese anemic and Group 2 (13) lean non anemic. Corresponding newborns of group 1 and 2 only where studied for their iron stores and Group 3 (9) obese non anemic pregnant.Results: Comparing group 1, 2 revealed significant differences in median values of Hepcidin (p 0.001), serum iron (p 0.001). No significant differences in Iron stores among newborns. Comparing group 1, 3 revealed no significant differences in Hepcidin (p=0.092).Using TRI (transferrin receptor index) cutoff=2.2 group 1 participants were categorized to; Group 1A and Group 1B. Their comparison revealed that there were significant differences in median values of, maternal TRI (p=0.001), maternal TSI (p=0.001). No significant differences in Hepcidin, nor Iron stores of infants.There was significant correlations seen between BMI and Hepcidin (r=0.051, p=0.002), and Hb (r=–0.350, p=0.029). Hepcidin was correlated to CRP (r=0.489, p=0. 002), SF (r= 0.391, p=0.018), S.iron (r=–0.392, p=0.018). Fetal ferritin was correlated to maternal CRP (r=–0.376, p=0.041).Conclusion: Study showed that TRI cutoffs showed powerful potential in estimating prevalence and differentiating ID, IDA and AI in pregnant obese mothers. Adiposity was associated with significant elevation of inflammatory marker Hepcidin. Fetal iron stores did not correlate to maternal anemia. Fetal ferritin correlated to maternal CRP.