Mentzer Index in High-Risk Pregnancies: Anemia Screening and Management

Abstract

Anemia remains a common and critical health issue in high-risk pregnancies, leading to adverse outcomes for both the mother and fetus, including preterm birth, low birth weight, and maternal fatigue. Differentiating between the two most common causes of microcytic anemia—iron deficiency anemia (IDA) and thalassemia trait (TT)—is essential for appropriate management. The Mentzer Index, calculated by dividing the mean corpuscular volume (MCV) by the red blood cell (RBC) count, has been proposed as a simple and effective tool to distinguish between these two conditions. This review explores the role of the Mentzer Index in anemia screening and management, particularly in high-risk pregnancies, where timely and accurate diagnosis is crucial for improving health outcomes. The application of the Mentzer Index in high-risk pregnancies offers a quick and cost-effective method for clinicians to identify whether the anemia is likely due to IDA or TT. A Mentzer Index score below 13 typically suggests thalassemia trait, while scores above 13 generally point toward iron deficiency anemia. While useful, the Mentzer Index is not definitive on its own and should be complemented by other diagnostic tests, such as hemoglobin electrophoresis, serum ferritin, and transferrin saturation, to confirm the underlying cause of anemia. By integrating these methods, healthcare providers can better tailor treatment plans, ensuring that women with IDA receive appropriate iron supplementation while avoiding iron overload in those with thalassemia trait.

Keywords: Mentzer Index, high-risk pregnancies, anemia screening, iron deficiency anemia, thalassemia trait