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Therefore, this study assessed the iron status and factors associated with iron deficiency (ID) using serum ferritin concentration among pregnant women in Haramaya district, eastern Ethiopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. The serum ferritin (SF) concentration was measured in the National Biochemical Laboratory of Ethiopia on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer using the electro-chemiluminescence (ECL) method and standard procedures. A log-binomial regression analysis identified variables associated with iron deficiency, and defined as serum ferritin concentration\u2009&lt;\u200915\u2009\u03bcg\/L (per the World Health Organization recommendation in developing countries). An adjusted risk ratio (aRR), and a 95% confidence interval (CI), were used to report associations. Finally, the<jats:italic>p<\/jats:italic>-value &lt;\u20090.05 was the cut-off point for the significant association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 446 pregnant women with a mean age of 24.78 (+\u20095.20) were included in the study. A total of 236 (52.91%; 95% CI: 48.16\u201357.63) had iron deficiency. The overall prevalence of anemia and iron deficiency anemia (IDA) was 45.96% (95% CI: 41.32\u201350.71) and 28.03% (95% CI: 21.27\u201332.44), respectively. The risk of iron deficiency was more likely among women with low dietary diversity (aRR\u2009=\u20091.36; 95% CI\u2009=\u20091.07\u20131.72) and those who skipped meals (aRR\u2009=\u20091.29; 95% CI\u2009=\u20091.05\u20131.57), but less among women who had antenatal care (aRR\u2009=\u20090.73 (95% CI\u2009=\u20090.61\u20130.88).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>More than half of the pregnant women in eastern Ethiopia had iron deficiency. Improving dietary diversity, meal frequency, and prenatal follow-up is essential to improve the high burden of ID and the adverse effect on pregnant women and the fetus. Moreover, a prospective study comparing maternal and perinatal outcomes among these spectra\u2014iron depletion, ID, and IDA\u2014is crucial for understanding their impact on maternal and perinatal mortality and morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40795-022-00579-8","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T06:02:58Z","timestamp":1660716178000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Beyond hemoglobin: uncovering iron deficiency and iron deficiency anemia using serum ferritin concentration among pregnant women in eastern Ethiopia: a community-based study"],"prefix":"10.1186","volume":"8","author":[{"given":"Meseret Belete","family":"Fite","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demiraw","family":"Bikila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wossene","family":"Habtu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abera Kenay","family":"Tura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tesfaye Assebe","family":"Yadeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lemessa","family":"Oljira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedir Teji","family":"Roba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,17]]},"reference":[{"key":"579_CR1","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1017\/S1368980008002401","volume":"12","author":"E Mclean","year":"2009","unstructured":"Mclean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. 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Indian J Nat Sci. 2020;10(59):18466\u201374.","journal-title":"Indian J Nat Sci"}],"container-title":["BMC Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40795-022-00579-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40795-022-00579-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40795-022-00579-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T21:25:42Z","timestamp":1700947542000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnutr.biomedcentral.com\/articles\/10.1186\/s40795-022-00579-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,17]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["579"],"URL":"https:\/\/doi.org\/10.1186\/s40795-022-00579-8","relation":{},"ISSN":["2055-0928"],"issn-type":[{"value":"2055-0928","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,17]]},"assertion":[{"value":"27 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in agreement with the Declaration of Helsinki-Ethical principle for medical research involving human subjects []. The proposal was approved by the Institutional Health Research Ethics Review Committee (IHRERC) of the College of Health and Medical Sciences, Haramaya University (ref No: IHRERC\/266\/2020). Written informed consent was obtained from all participants and legally authorized representatives \u201cof minors below 16\u2009years of age and illiterates\u201d and confidentiality was maintained by excluding all personal identifiers.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflicts of interest in this work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"82"}}