title: Maternal serum ferritin as a clinical tool at 34-36 weeks' gestation for distinguishing subgroups of fetal growth restriction.
abstract: OBJECTIVE
  To compare maternal ferritin levels across pregnancies with fetal growth restriction including SGA and IUGR compared to appropriate for gestational age (AGA).
  
  
  METHODS
  Three groups were enrolled: AGA, SGA (birth weight below 10th percentile for gestational age with no placental insufficiency findings), and IUGR (birth weight below 5th percentile for gestational age accompanied by abnormal umbilical artery Doppler waveforms and/or oligohydramnios). Maternal serum ferritin samples were obtained at gestational weeks 34 through 36, and delivery occurred at or beyond 36 weeks.
  
  
  RESULTS
  A total of 126 pregnancies with AGA (36%), SGA (40%), and IUGR (24%) were enrolled. The mean maternal serum ferritin level was higher in the IUGR group than in the AGA group (59 μg/l versus 32.5 μg/l, p < 0.001). A maternal serum ferritin cutoff of 48 μg/l was found to be optimal for distinguishing between IUGR and AGA with a sensitivity of 67.7%, specificity of 92%, PPV of 84%, NPV of 82%, diagnostic accuracy of 82.7%, LR + of 8 and LR- of 0.3, respectively.
  
  
  CONCLUSIONS
  Maternal serum ferritin levels differ in pregnancies with IUGR. The role of maternal serum ferritin measurements as a clinical tool for distinguishing different forms of fetal growth restriction warrants further investigation.
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Perinatology, Faculty of Medicine, Suleyman Demirel University , Isparta , Turkey.
authors.forename: Mehmet Ozgur
authors.initials: MO
authors.lastname: Akkurt
authors.affiliation: b Department of Obstetrics and Gynecology , Isparta Maternity and Children's Hospital , Isparta , Turkey.
authors.forename: Iltac
authors.initials: I
authors.lastname: Akkurt
authors.affiliation: c Department of Obstetrics and Gynecology , Etlik Zubeyde Hanim Maternity and Women's Health Teaching and Research Hospital , Ankara , Turkey , and.
authors.forename: Metin
authors.initials: M
authors.lastname: Altay
authors.affiliation: c Department of Obstetrics and Gynecology , Etlik Zubeyde Hanim Maternity and Women's Health Teaching and Research Hospital , Ankara , Turkey , and.
authors.forename: Bora
authors.initials: B
authors.lastname: Coskun
authors.affiliation: d Department of Obstetrics and Gynecology , Zekai Tahir Burak Maternity and Women's Health Teaching and Research Hospital , Ankara , Turkey.
authors.forename: Salim
authors.initials: S
authors.lastname: Erkaya
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Perinatology, Faculty of Medicine, Suleyman Demirel University , Isparta , Turkey.
authors.forename: Mekin
authors.initials: M
authors.lastname: Sezik
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D005317:Fetal Growth Retardation / Q000145:classification / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D011247:Pregnancy; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005293:Ferritins
keywords: Acute phase reactant; ferritin; fetal growth restriction; small for gestational age