Biochemical Assessment of Serum Hepcidin, Ferritin and Transferrin Saturation in Pregnant Women with Iron Deficiency Anemia in Thi-Qar Province – Iraq

Abstract

Objective: To assess serum hepcidin, ferritin, and transferrin saturation levels in pregnant women with iron deficiency anemia, and to explore their interrelationships as well as their possible diagnostic value as a combined
biomarker panel

Study Design: Case-control observational study
Place and Duration of Study: This study was conducted at the outpatient antenatal clinics of Al-Nasiriyah Teaching Hospital, Thi-Qar Province – Iraq, from 15th August 2025 to 30th June 2026.

Methodology: Ninety pregnant women in their second and third trimesters were recruited, 60 women with iron deficiency anemia and 30 healthy pregnant controls. Venous blood samples were taken for the estimation of
complete blood count, serum iron, total iron binding capacity, ferritin and hepcidinby enzyme-linked immunosorbent assay. Transferring saturation was computed as serum iron/total iron binding capacity.

Results: Compared with controls, women with iron deficiency anemia exhibited significantly lower levels of hemoglobin, ferritin and transferring saturation, with markedly reduced hepcidin concentrations (P<0.001 for each). Hepcidin correlated well with ferritin (r=0.71) and transferring saturation (r=0.62) and moderately with hemoglobin. Receiver operating characteristic analysis showed hepcidin had an excellent discriminative capacity for iron deficiency anemia (AUC = 0.91).

Conclusion: The addition of hepcidin to the standard iron parameters and its potential as a supplementary marker to improve the diagnosis of iron deficiency anemia in pregnancy.