Publication:

Correlation between red cell indices and serum ferritin level in pregnant women with latent iron deficiency

Background Latent iron deficiency (LID), defined as iron depletion without anemia, frequently precedes iron deficiency anemia in pregnancy and is associated with adverse maternal and fetal outcomes. Serum ferritin is the gold standard for assessing iron stores but is often unavailable in low-resource settings. Readily obtainable red cell indices may serve as practical alternatives for identifying early iron deficiency. This study aimed to evaluate the relationship between red cell indices and serum ferritin levels among pregnant women with latent iron deficiency.

Methods This cross-sectional analytical study was conducted at Sir Salimullah Medical College Mitford Hospital, Dhaka, including 205 non-anemic pregnant women in their second trimester. Complete blood count and serum ferritin were assessed using automated analyzers. Participants were categorized as latent iron-deficient (ferritin 0.05). RDW-CV% was significantly higher in LID women (15.3±1.6 vs 14.1±1.6, p<0.001). A significant negative correlation was observed between RDW-CV% and serum ferritin (r = -0.347, p<0.001).

Conclusions RDW-CV% demonstrates a strong negative correlation with serum ferritin and may be used as a sensitive hematologic marker for early detection of latent iron deficiency in pregnancy. Integrating RDW interpretation into routine antenatal blood count assessments can improve screening and management of iron deficiency in resource-limited settings.