Utility of new reticulocyte parameters such as reticulocyte hemoglobin and new erythrocyte parameters in detection of subclinical stage of iron deficiency in pregnancy

Background: Deficiency of iron is the most common cause of anemia in pregnancy. It may cause various morbidities in pregnancy. Hemoglobin estimation is the routine investigation employed in antenatal screening where 11g/dl is taken as a cut-off for diagnosis of anemia. With the advancement of technology, new reticulocyte and erythrocyte parameters, such as the percentage hypochromic red blood cells and the percentage Microcytic Red Blood Cells (Micro-R), can assess iron status. Hence, in the present study, utility of these parameters was evaluated to determine the subclinical stage of iron deficit in pregnancy. Aim and Objectives: To assess utility of newer reticulocyte and erythrocyte parameters by comparing them with serum iron for detecting subclinical deficiency of iron in pregnancy. Material and Methods: Hospital-based, observational study was done on blood samples of non-anemic females of first-trimester pregnancy presenting to the obstetrics and gynecology department for the first time. Unpaired t-test and receiver operating characteristic analysis were done to check the relative efficiency. Results: Reticulocyte Hemoglobin (Ret-He) showed a sensitivity of 98.0% and specificity of 97.0% at the optimal value of 32.25. The area under the curve for Ret-He indicated it as a discriminator of deficiency of iron with a p-value < 0.001. Micro-R percentage at a cut-off of 1.55 showed sensitivity and specificity of 76.9% and 69.9%, respectively, and was statistically significant. Conclusion: Ret-He can be an alternative hematological investigation for detecting subclinical deficiency of iron in females during pregnancy.