Comparative Evaluation of Serum Iron and Folic acid Concentrations between the second and third Trimesters among Multiparous Pregnant Women

Abstract

Iron and folic acid are essential micronutrients required for maternal health and optimal fetal growth during pregnancy. Multiparous pregnant women are particularly vulnerable to micronutrient deficiencies because of repeated pregnancies and increased physiological demands. This study aimed to compare serum iron and folic acid concentrations between the second and third trimesters of pregnancy among multiparous women. A comparative observational study was conducted among 150 multiparous pregnant women. Serum iron and serum folic acid concentrations were measured during the second and third trimesters using standard laboratory procedures. Descriptive statistics were calculated, including mean, standard deviation, median, range, variance, and 95% confidence intervals. Statistical significance was determined at p < 0.05. The mean serum iron concentration decreased significantly from 67.99 ± 9.96 µg/dL in the second trimester to 43.60 ± 6.27 µg/dL in the third trimester (p < 0.001). Median values declined from 68.4 µg/dL to 42.75 µg/dL, while the 95% confidence intervals (66.38–69.60 µg/dL and 42.57–44.63 µg/dL, respectively) showed no overlap, confirming a statistically significant reduction. Likewise, mean serum folic acid concentration declined markedly from 8.56 ± 1.22 ng/mL during the second trimester to 3.77 ± 0.67 ng/mL in the third trimester. The 95% confidence intervals (8.36–8.76 ng/mL and 3.66–3.88 ng/mL, respectively) also demonstrated a significant decrease. Reduced variance and narrower ranges observed in the third trimester indicated a consistent decline in both micronutrients across the study population. The progressive reduction in serum iron and folic acid concentrations during late pregnancy reflects the increased maternal and fetal nutritional requirements associated with advancing gestation. The findings suggest that multiparous women are at greater risk of developing iron and folate deficiencies during the third trimester, potentially increasing the likelihood of maternal anemia, impaired fetal growth, low birth weight, and adverse pregnancy outcomes. These results emphasize the importance of continuous nutritional monitoring and timely supplementation throughout pregnancy. Serum iron and folic acid concentrations decline significantly from the second to the third trimester among multiparous pregnant women. Routine screening, nutritional counseling, and appropriate iron and folic acid supplementation, particularly during the third trimester, are essential to prevent maternal micronutrient deficiencies and improve maternal and neonatal health outcomes.