Growth Differentiation Factor-15 and Erythroferrone are Reliable Predictors of Iron Status among Iraqi Pregnant Women with Anemia: A Case-Control Study

Background: It is estimated that more than half of pregnant women all over the world are anemic. The potential of erythroferrone (ERFE) and growth differentiation factor-15 (GDF15) as indicators for iron deficiency could be used to detect various types of anemia, cardiovascular and metabolic diseases. Objectives: To assess whether variations in erythroferrone and Growth Differentiation Factor-15 in blood levels among pregnant women might be used as a marker for anemia. Methods: A cross-sectional study recruited 120 pregnant women into a study group: 60 anemic pregnant women and 60 healthy pregnant controls. Their demographics, hematological indices, and biomarkers (growth differentiation factor-15, erythroferrone, serum ferritin and iron) were collected. Results: It has been found that anemic pregnant women have statistically higher levels of Growth Differentiation-15, Erythroferrone, and other iron status compared to healthy pregnant women. The average concentration of ERFE in anemic pregnant women was 5.6 ng/mL, while in healthy pregnant women, it was 2.2 ng/mL. For GDF-15, the average concentration was 457.27 pg/mL for anemic patients and 228.89 pg/mL for healthy pregnant women. The cutoff value of both GDF-15 and ERFE had the highest sensitivity and specificity in differentiating anemic pregnant women, 1.000 (p<0.0001) for the area under the curve in the case of healthy controls. Conclusions: The markers erythroferrone and GDF-15 have a significant correlation with iron indicators and are recommended for screening anemic pregnant women.