Can serum ferritin predict thyroid performance in the first trimester?

OBJECTIVE: The primary aim of the study was to establish a reference value for the thyroid hormone in the first trimester of pregnancy in Iraq's population. The second aim was to look into the correlation between iron deficiency anaemia and thyroid hormone. METHODS: In a cross-sectional study conducted at the National Center of Haematology, 74 consented pregnant women at a gestational age < 13 weeks were recruited. An estimation was made for iron indices [haemoglobin, serum ferritin] and Thyroid Function Test [Triiodothyronine, Thyroxine and Thyroid-stimulating hormone] via collected blood samples. RESULTS: The reference value for thyroid hormones was 1.79±2.05 pmol / l for Thyroid-stimulating hormone, 4.59±3.35 pmol / l for Thyroxine and 191±62.1 ng/dl for Triiodothyronine. Correlation showed an inverse relationship of Thyroid-stimulating hormone with serum haemoglobin and a positive correlation between Triiodothyronine and Thyroxine versus serum haemoglobin and ferritin. Mallow's coefficient of correlation evaluated the strength of the association between serum haemoglobin against Thyroid-stimulating hormone, Triiodothyronine, and Thyroxine. The strongest association was for Thyroxine.Thyroid-stimulating hormone, Thyroxine, and Triiodothyronine taken as independent variables were challenged against serum ferritin and haemoglobin as dependent variables. The only significant correlation was for serum ferritin and thyroid markers. CONCLUSIONS: First-trimester screening for ferritin, in addition to routine haemoglobin testing, can reveal masked depleted iron stores. Hidden thyroid disease can be associated with anaemia, so Thyroid-stimulating hormone screening is recommended. Early diagnosis of these deficiencies in the first trimester will stop their impact on both the foetus and the mother's well being.

The value of neutrophils/lymphocyte ratio in predicting foetuses that need urgent delivery in post-term pregnancies: A prospective study.

OBJECTIVE: To verify the performance of neutrophils ratio to the natural logarithm of lymphocyte ratio in detecting foetuses requiring urgent delivery in post-term pregnancies. METHODS: The prospective observational study was conducted from June 2019 to March 2020, at the University Hospital, Baghdad, Iraq, and comprised post-term pregnant females at a gestational age of 40-41+3 days who were followed up until delivery. Demographic data was recorded for each patient, and all of them were subjected to Doppler examination of biophysical profile and amniotic fluid index. Complete blood count was done to generate neutrophils ratio to the natural logarithm of lymphocyte ratio. Receiver operating characteristic curve determined the cut-off value, sensitivity and specificity of neutrophils ratio to the natural logarithm of lymphocyte ratio. RESULTS: There were 74 post-term pregnant women with a mean age of 28.95±6.71 years and the mean foetal age at delivery was 287.38±3.72 days. Of the total, 49(66.22%) women were delivered >10 days post-term, while 25(33.78%) were delivered urgently <10 days post-term because of regression in their biophysical profile score and foetal compromise. The neutrophils ratio to the natural logarithm of lymphocyte ratio showed significant correlation with biophysical profile and amniotic fluid index scores (p<0.05). The ratio cut-off value was found to be >21.6 associated with highest sensitivity and specificity of 81% and 87.5% respectively. Area under the curve was 0.89 (p<0.001). CONCLUSION: Neutrophils ratio to the natural logarithm of lymphocyte ratio identified foetuses who needed urgent termination in post-term pregnancies.