Maternal Serum Ferritin Level in Prediction of Mothers with Appropriate-For-Gestational-Age (AGA), Small-For-Gestational Age (SGA), and Intrauterine Growth Restriction (IUGR)

Background Fetal growth restriction is one of the main causes of perinatal mortality that can be predicted by ferritin. We aimed to evaluate the role of ferritin in prediction of mothers with Appropriate-for-gestational-age (AGA), Small-for-gestational age (SGA) and intrauterine growth restriction (IUGR). Materials and Methods: In this cohort study, we screened 73 mothers with gestational ages of 32-34 weeks. If amniotic fluid index (AFI) was normal and there was no circulation defect, the fetuses were classified in SGA group and in case of presence of oligohydramnios or circulation defect; they were classified in IUGR group. Also, fetuses with normal growth were classified in AGA group. We evaluated the serum ferritin, hemoglobin, and iron of the mothers. Moreover, we evaluated the levels of placenta ferritin, Hb, and hematocrit in the delivery room. Results: In this study, 28 patients were categorized in AGA group, 15 patients in SGA group and 30 patients in IUGR group. Mean weight of all infants was 2210.60 ± 932.77 grams. Also, the mean AFI of all infants was 9.81 ± 3.59. The mean ferritin level of all mothers was 30.29 ± 10.80 and IUGR group had the highest and AGA group had the lowest ferritin levels (P=0.015). Maternal ferritin (μg/l) (Sen: 67.9%, Sp: 61.9%), maternal hematocrit (%) (Sen: 70%; Sp: 62.8%,) and maternal Hb (Sen: 70%, Sp: 65.1%,) could predict IUGR. Conclusion Increased (>34 μg/l) and decreased (<26 μg/l) levels of maternal serum ferritin level may be correlated with IUGR and SGA fetuses, respectively. Thus, measurement of maternal serum ferritin level in addition to sonography can be a useful marker in differentiating SGA and IUGR fetuses.