title: Development of a clinical prediction rule for iron deficiency anemia in pregnancy.
abstract: OBJECTIVE
  The purpose of this study was to elucidate if anemia in pregnancy caused by iron deficiency could be predicted by simple measures obtained on a complete blood count (CBC) using ferritin as the gold standard.
  
  
  METHODS
  One hundred forty-one pregnant patients with anemia were recruited during their first prenatal visit. CBC and ferritin level were obtained and candidate-predictors identified. Receiver operator characteristic (ROC) curves, stratified analysis, and logistic regression analysis were used to develop a prediction rule with maximum specificity.
  
  
  RESULTS
  A hemoglobin level < or = 9.7 and a red cell distribution width (RDW) > or = 15 (in gestational age <20 weeks) predicted iron deficiency with high specificity. Our final model correctly classified 79.43% of the patients (area under the ROC curve of 0.88 [95%CI 0.82-0.93], specificity of 95.74%).
  
  
  CONCLUSIONS
  Iron deficiency anemia can be predicted in pregnancy using lower cost tests, which could be an incredibly useful tool in areas with limited resources and a high prevalence of the disease. This study was limited to a mostly African American population in an urban setting, and the results may not be generalized to other populations.
authors.affiliation: Department of Obstetrics and Gynecology, Pennsylvania Hospital, University of Pennsylvania, Philadelphia 19107, USA. casanovb@pahosp.com
authors.forename: Bruno F
authors.initials: BF
authors.lastname: Casanova
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis*; D001772:Blood Cell Count; D005260:Female; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity