Serum Ferritin and Plasma Fibrinogen Levels among Pregnant Women Attending Antenatal Clinic at Federal Teaching Hospital, Owerri, Imo State, Nigeria

Abstract

Background: Pregnancy is accompanied by substantial physiological changes in iron metabolism and haemostasis. Although many of these changes are normal adaptations to pregnancy, marked alterations may contribute to maternal anaemia and thrombotic complications. Ferritin provides an indirect assessment of body iron stores, while fibrinogen is an important coagulation protein whose concentration increases during pregnancy as part of the physiological hypercoagulable state. Objectives: This study evaluated serum ferritin and plasma fibrinogen levels among pregnant women attending antenatal clinics at Federal Teaching Hospital, Owerri, Imo State, Nigeria. Methods: The study comprised 120 women, consisting of 60 apparently healthy non-pregnant women who served as controls and 60 pregnant women distributed across the first, second and third trimesters. Five millilitres of venous blood were collected from each participant. Two millilitres were dispensed into a sodium citrate container for fibrinogen estimation, while the remaining 3 mL were dispensed into a plain container for serum ferritin estimation. Data generated were analysed using analysis of variance (ANOVA) and Student's t-test. Results: Ferritin levels among pregnant women showed a progressive decline across pregnancy, from (65.64 ± 4.25)ng/ml in the first trimester to (56.59 ± 3.56)ng/ml in the second trimester and (45.69 ± 5.39)ng/ml in the third trimester. Compared to non-pregnant women (64.05 ± 2.34), the difference was not statistically significant in the first trimester (p = 0.737) or second trimester (p = 0.105), but was significantly lower in the third trimester (p = 0.001). In contrast, fibrinogen levels were significantly higher among pregnant women in all trimesters compared to non-pregnant controls (187.29 ± 8.62)mg/dl, with values of (347.29 ± 19.47)mg/dl, (390.21 ± 17.23)mg/dl and (359.79 ± 18.44)mg/dl in the first, second and third trimesters, respectively (p < 0.001 for all comparisons). Conclusion: The reduction in ferritin with advancing gestation suggests progressive utilisation of maternal iron stores, while the increase in fibrinogen reflects the haemostatic adaptation of pregnancy. These findings demonstrate that ferritin and fibrinogen may provide useful complementary information during antenatal assessment. Routine monitoring of iron stores and haemostatic status, particularly in women at increased risk of anaemia or thrombotic complications, may improve maternal care.