ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Hepcidin, Ferroportin, and Hemoglobin as Predictors of Iron Deficiency Anemia Risk and Perinatal Outcomes in Twin Pregnancy
Provisionally accepted
- 1Department of Gynaecology and Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- 2Department of Scientific Research, The Second People’s Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China
- 3Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
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Objective: This study investigated iron-deficiency anemia (IDA), third-trimester hepcidin and ferroportin levels, and perinatal outcomes in twin pregnancies. Study Design: Pregnant women with twin gestations (n = 195) were enrolled and classified into an IDA group (n = 63; further subdivided into adverse and non-adverse perinatal-outcome subgroups) and a non–iron-deficiency anemia group (n = 132). Serum hepcidin and ferroportin were measured at ≥28 weeks of gestation. Analyses included multivariate logistic regression and receiver operating characteristic curve assessments. Results: The prevalence of IDA was 32.3%. Hepcidin showed positive correlations with red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Ferroportin showed negative correlations with these indices as well as with hepcidin. Adverse outcomes occurred in 84.1% of pregnancies complicated by iron-deficiency anemia. The combined decrease in hepcidin and hemoglobin levels, together with an increase in ferroportin concentrations, yielded an area under the curve of 0.940 for predicting adverse outcomes. Conclusion: IDA is common in twin pregnancies and is strongly associated with unfavorable maternal–fetal outcomes. The combined measurement of hepcidin, ferroportin, and hemoglobin has diagnostic and predictive value in assessing iron-deficiency anemia in twin pregnancies.
Keywords: Twin pregnancy, iron deficiency anemia, hepcidin, Ferroportin, Perinatal outcomes
Received: 11 Sep 2025; Accepted: 12 Nov 2025.
Copyright: © 2025 Zhong, Deng, Xu, Zhou, Yan and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jinfu Zhou, zhou811203@fjmu.edu.cn
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