Screening for Thalassemia Traits in Pregnancy: The Role of Mentzer Index

Emmanuel Ifeanyi Obeagu; Getrude Uzoma Obeagu

doi:10.22270/ijmspr.v10i4.123

Authors

Emmanuel Ifeanyi Obeagu Department of Medical Laboratory Science, Kampala International University, Uganda. https://orcid.org/0000-0002-4538-0161
Getrude Uzoma Obeagu School of Nursing Science, Kampala International University, Uganda.

DOI:

https://doi.org/10.22270/ijmspr.v10i4.123

Keywords:

Thalassemia, pregnancy, Mentzer Index, anemia, screening, complete blood count, maternal health, carrier detection

Abstract

Thalassemia traits present significant challenges during pregnancy, often leading to complications such as anemia and adverse maternal and fetal outcomes. Early identification of carriers is essential for managing these risks and providing appropriate care. This review article examines the Mentzer Index, a straightforward and cost-effective tool derived from complete blood count (CBC) parameters, which can effectively screen for thalassemia traits in pregnant women. By calculating the ratio of mean corpuscular volume (MCV) to red blood cell (RBC) count, the Mentzer Index serves as a valuable first-line screening measure, facilitating timely referrals for further diagnostic testing. The relevance of early detection is underscored by the need for informed reproductive choices and tailored management strategies. Recognizing thalassemia traits allows healthcare providers to monitor affected women closely and implement appropriate interventions, ultimately improving maternal health outcomes. Furthermore, the Mentzer Index is easily applicable in various clinical settings, particularly in resource-limited environments where access to advanced laboratory testing may be limited.

Keywords: Thalassemia, pregnancy, Mentzer Index, anemia, screening, complete blood count, maternal health, carrier detection.

Author Biographies

Emmanuel Ifeanyi Obeagu , Department of Medical Laboratory Science, Kampala International University, Uganda.

Department of Medical Laboratory Science, Kampala International University, Uganda.

Getrude Uzoma Obeagu , School of Nursing Science, Kampala International University, Uganda.

School of Nursing Science, Kampala International University, Uganda.

References

Rahman MM, Abe SK, Rahman MS, Kanda M, Narita S, Bilano V, Ota E, Gilmour S, Shibuya K. Maternal anemia and risk of adverse birth and health outcomes in low-and middle-income countries: systematic review and meta-analysis. The American journal of clinical nutrition. 2016; 103(2):495-504. https://doi.org/10.3945/ajcn.115.107896 PMid:26739036

Obeagu EI, Ezimah AC, Obeagu GU. Erythropoietin in the anaemias of pregnancy: a review. Int J Curr Res Chem Pharm Sci. 2016;3(3):10-8. https://doi.org/10.22270/ijmspr.v10i2.95

Okamgba OC, Nwosu DC, Nwobodo EI, Agu GC, Ozims SJ, Obeagu EI, Ibanga IE, Obioma-Elemba IE, Ihekaire DE, Obasi CC, Amah HC. Iron Status of Pregnant and Post-Partum Women with Malaria Parasitaemia in Aba Abia State, Nigeria. Annals of Clinical and Laboratory Research. 2017;5(4):206.

Petrakos G, Andriopoulos P, Tsironi M. Pregnancy in women with thalassemia: challenges and solutions. International journal of women's health. 2016:441-451. https://doi.org/10.2147/IJWH.S89308 PMid:27660493 PMCid:PMC5019437

Obeagu EI, Adepoju OJ, Okafor CJ, Obeagu GU, Ibekwe AM, Okpala PU, Agu CC. Assessment of Haematological Changes in Pregnant Women of Ido, Ondo State, Nigeria. J Res Med Dent Sci. 2021 Apr;9(4):145-8.

Agreen FC, Obeagu EI. Anaemia among pregnant women: A review of African pregnant teenagers. Journal of Public Health and Nutrition. 2023;6(1):138.

Arora S, Rana D, Kolte S, Dawson L, Dhawan I. Validation of new indices for differentiation between iron deficiency anemia and beta thalessemia trait, a study in pregnant females. International Journal of Scientific Reports. 2018; 4(2):26. https://doi.org/10.18203/issn.2454-2156.IntJSciRep20180394

Tabassum S, Khakwani M, Fayyaz A, Taj N. Role of Mentzer index for differentiating iron deficiency anemia and beta thalassemia trait in pregnant women. Pakistan Journal of Medical Sciences. 2022;38(4Part-II):878. https://doi.org/10.12669/pjms.38.4.4635

Matos JF, Dusse LM, Stubbert RV, Ferreira MR, Coura-Vital W, Fernandes AP, de Faria JR, Borges KB, Carvalho MD. Comparison of discriminative indices for iron deficiency anemia and β thalassemia trait in a Brazilian population. Hematology. 2013 May 1;18(3):169-74. https://doi.org/10.1179/1607845412Y.0000000054 PMid:23321282

Iolascon A, Andolfo I, Russo R, Sanchez M, Busti F, Swinkels D, Aguilar Martinez P, Bou‐Fakhredin R, Muckenthaler MU, Unal S, Porto G. Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia. Hemasphere. 2024; 8(7):e108. https://doi.org/10.1002/hem3.108 PMid:39011129 PMCid:PMC11247274

Obeagu EI, Obeagu GU, Chukwueze CM, Ikpenwa JN, Ramos GF. Evaluation of protein C, protein S and fibrinogen of pregnant women with malaria in Owerri metropolis. Madonna University journal of Medicine and Health Sciences ISSN: 2814-3035. 2022 Apr 19;2(2):1-9.

Obeagu EI, Obeagu GU. Neonatal Outcomes in Children Born to Mothers with Severe Malaria, HIV, and Transfusion History: A Review. Elite Journal of Nursing and Health Science, 2024; 2(3): 38-58

Sahli CA, Bibi A, Ouali F, Fredj SH, Dakhlaoui B, Othmani R, Laouini N, Jouini L, Ouenniche F, Siala H, Touhami I. Red cell indices: differentiation between β-thalassemia trait and iron deficiency anemia and application to sickle-cell disease and sickle-cell thalassemia. Clinical Chemistry and Laboratory Medicine (CCLM). 2013; 51(11):2115-24. https://doi.org/10.1515/cclm-2013-0354 PMid:23800659

Hoffmann JJ, Nabbe KC, van den Broek NM. Effect of age and gender on reference intervals of red blood cell distribution width (RDW) and mean red cell volume (MCV). Clinical Chemistry and Laboratory Medicine (CCLM). 2015; 53(12):2015-9. https://doi.org/10.1515/cclm-2015-0155 PMid:26536583

Miftahussurur M, Husada D, Ningtyas WS. Association of shine and LAL index β-thalassemia trait screening results with anaemia and low birth weigh. international journal of nursing and midwifery science (IJNMS). 2023; 7(3):290-296. https://doi.org/10.29082/IJNMS/2023/Vol7/Iss3/543

Shahid H, Saleem M, Naseer N, Tabussam S, Aziz A, Ullah S. Evaluation of Srivastava index to distinguishing Beta-Thalassemia Trait from Iron Deficiency. Pakistan Journal of Medical & Health Sciences. 2022;16(05):1225-. https://doi.org/10.53350/pjmhs221651225

Vehapoglu A, Ozgurhan G, Demir AD, Uzuner S, Nursoy MA, Turkmen S, Kacan A. Hematological indices for differential diagnosis of Beta thalassemia trait and iron deficiency anemia. Anemia. 2014; 2014(1):576738. https://doi.org/10.1155/2014/576738 PMid:24818016 PMCid:PMC4003757

Urrechaga E. Discriminant value of % microcytic/% hypochromic ratio in the differential diagnosis of microcytic anemia. Clinical chemistry and laboratory medicine. 2008;46(12):1752-1758. https://doi.org/10.1515/CCLM.2008.355 PMid:19055451

Obeagu EI, Obeagu GU. Impact of Maternal Eosinophils on Neonatal Immunity in HIV- Exposed Infants: A Review. Elite Journal of Immunology, 2024; 2(3): 1-18 https://doi.org/10.22270/ajdhs.v4i2.82