ASSOCIATION OF MATERNAL SERUM FERRITIN WITH NEWBORN OUTCOMES AMONG ANTENATAL WOMEN AT A TERTIARY CARE HOSPITAL

Abstract

Background: Maternal iron status is critical to fetal development. While nutritional iron deficiency anemia remains a major focus in maternal public health, emerging evidence suggests that elevated serum ferritin acting either as a marker of iron excess or an acute-phase reactant, may paradoxically be linked to adverse pregnancy outcomes, including spontaneous preterm labor. Objectives: To evaluate the association between maternal serum ferritin concentration at the time of delivery and immediate newborn outcomes (birth weight and gestational age) among antenatal mothers at a tertiary care hospital in Kakinada. Methods: A cross-sectional study was conducted from April to December 2025 involving 208 antenatal mothers admitted for safe institutional delivery. High-risk maternal conditions altering iron metabolism or baseline inflammation (e.g., thalassemia traits, gestational diabetes, pregnancy-induced hypertension, HIV, HBsAg, antepartum hemorrhage, and severe systemic infections) were excluded. Data was collected by semi-structured questionnaires and pre-delivery serum ferritin estimation was done. Analysis was performed utilizing SPSS v26 using descriptive statistics, Chi-square test, and Pearson correlation coefficients. Results: The study presented a high baseline prevalence of anemia (63.5%). Low serum ferritin (<15 ng/ml) was seen in 45.2% of participants, normal levels (15–150 ng/ml) in 51.9%, and high levels (>150 ng/ml) in 2.9% (Mean: 31.4 + 53.4ng/ml). Low birth weight (LBW) occurred in 12.0% of deliveries but no statistically significant association with their baseline ferritin levels (p > 0.05). However, preterm birth (8.2%) was significantly higher among mothers presenting with elevated serum ferritin (p< 0.05). A notable negative correlation was verified between gestational age and serum ferritin (p < 0.05). Conclusion: Elevated maternal serum ferritin at delivery is significantly associated with shortened gestational age and preterm delivery. Role of Ferritin as an inflammatory biomarker highlights its clinical utility in risk-stratifying adverse neonatal outcomes beyond standard hemoglobin screening.