Association of Antenatal Maternal Ferritin Levels and Preterm Birth in a Tertiary Centre in Malaysia
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Abstract
Introduction: It is well known that preterm birth (PTB) contributes to perinatal mortality and long-term morbidity. Elevated serum ferritin levels have been frequently reported in PTB compared to term births; however, most studies had blood samples taken during the peripartum period. We aim to evaluate the relationship between antenatal serum ferritin levels and PTB. Methods: A retrospective study of pregnant women delivered at our hospital between January 2013 and December 2020 was conducted. Demographic data, medical history, gestation, and blood ferritin results were retrieved from the hospital and laboratory information system. Patients with maternal serum ferritin measured antenatally who were not documented to have chronic diseases, infection, iron disorders, multiple gestations, and uterine or cervical anomalies were included in the analysis. We compared the preterm and term groups’ ferritin levels and other risk factors. Results: Among 202 recruited women, 27 (14.4%) had spontaneous PTB. Most ferritin measurements (80%) were taken during the third trimester. There was no significant difference in the median ferritin levels between PTBs (15.81μg/L, IQR 10.09 – 32.41 μg/L) and term births (16.11μg/L, IQR 9.09 – 34.38 μg/L), P=0.801. However, ferritin levels in the second trimester nearly doubled that in the first trimester in the PTB group. PTB was associated with more cases of preeclampsia (P=0.003), a history of antepartum haemorrhage (p=0.040) and premature rupture of membrane status (P<0.001). Conclusion: Despite the elevation of ferritin levels in the second trimester, there is no significant association between maternal antenatal ferritin levels and PTB.
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