Can serum ferritin, vitamin B-12 and folic acid levels affect serum screening tests during pregnancy?

Abstract

Objective: To examine the relation of serum folate, vitamin B-12 and ferritin levels to 1st and 2nd trimester serum screening markers. Methods: Fetal crown-rump length (CRL), nuchal translucency (NT), and first and second trimester serum screening tests of 228 pregnant women were obtained. In all cases, serum vitamin B-12, folic acid and ferritin levels were analyzed during the 11-14 week period. Levels below <15 mu g/L, 3 ng/mL and 211 pg/mL were accepted as nutrient deficiency for serum ferritin, folic acid and vitamin B-12, respectively. Results of serum screening markers of women below and above these values were compared with each other. Results: Comparison of groups with ferritin levels <15 and >15 mu g/L for 1st and 2nd trimester serum screening parameters revealed significant differences between groups in terms of pregnancy associated plasma protein-A (PAPP-A), free beta-human chorionic gonadotropin (fb-hCG), AFP and hCG. Comparison of women with low versus normal B-12 levels revealed significant differences in terms of NT, PAPP-A and fb-hCG. Conclusion: Although sufficient, number of cases is limited in this study so results cannot be generalized to all population. It could be advised that in addition to folic acid supplementation, deficiencies of ferritin and B-12 must be corrected in patients considering pregnancy or early 1st trimester pregnant women to obtain more accurate serum screening results.