Hematological and Iron Profile Changes in Pregnant Women Across Trimesters
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Background: Iron requirements increase progressively during pregnancy, while physiological hemodilution and depletion of maternal iron reserves can alter hematological and biochemical indices across gestation. Objective: To evaluate trimester-wise changes in hemoglobin, mean corpuscular volume (MCV), serum ferritin, serum iron, total iron-binding capacity (TIBC), transferrin saturation, and anemia prevalence among pregnant women in Karachi, Pakistan. Methods: This prospective longitudinal study enrolled 150 pregnant women during the first trimester, of whom 138 completed assessments at 8–12, 20–24, and 32–36 weeks of gestation. Hematological and iron-profile parameters were measured at each assessment and trimester-wise changes were evaluated using repeated-measures statistical analysis. Results: Hemoglobin decreased from 11.8 ± 1.2 to 10.7 ± 1.1 g/dL (p<0.001), while MCV decreased from 84.6 ± 5.4 to 79.8 ± 6.1 fL (p=0.002). Ferritin declined from 38.5 ± 18.4 to 17.2 ± 11.5 ng/mL, serum iron from 86.4 ± 24.5 to 61.5 ± 20.6 µg/dL, and transferrin saturation from 28.1 ± 8.5% to 17.5 ± 7.1%, whereas TIBC increased from 312.6 ± 45.3 to 358.4 ± 52.1 µg/dL (all p<0.001). Anemia prevalence increased from 18.8% to 42.0%. Conclusion: Maternal hematological and biochemical iron-status indices deteriorated progressively across pregnancy, supporting trimester-sensitive assessment of iron status rather than reliance on hemoglobin alone
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