Anaemia in Pregnancy; An Underdeveloped Country’s Perspective (The First Ever Multicentre Trial in Pakistan from all Four Provinces)

Muhammad Irfan Khattak, Samina Naseem khattak, Shumaila Hadi, Samina Rehan Khan, Muhammad Numan Khattak, Adeela Yasmeen
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Abstract

Objective: To determine the true prevalence of anaemia in Pakistani mothers from all four provinces and compare the haematological parameters. Location: Multicentre study at PNS Shifa Karachi (Sind), CMH Kharian (Punjab), CMH Mardan (KPK), CMH Quetta (Balochistan). Duration: Apr-Sep 2021 for 6 months. Study design: prospective observational study. Methods: Four centres were established to collect data on a representative sample of each province. Along with haematological measures, sociodemographic data were obtained and placed into a predefined online proforma. SPSS v 20 was used to analyse the data. Frequencies and percentages were calculated for categorical variables, whereas means and standard deviations were used to represent scales. Results of all four provinces were analysed and compared for similarities and differences. Results: A total of 2060 female patients fulfilling our inclusion criteria from all four provinces were Obstet Gynecol Res 2022; 5 (1): 034-040 DOI: 10.26502/ogr076 Obstetrics and Gynecology Research Vol. 5 No. 1– March 2022. 35 included in the study. Four hundred and sixty (22%) of the total population were in the first trimester, 785 (38%) were in the second, and 815 (40%) were in the third trimester of pregnancy. The study population's mean age was 28 ± 5.033 years. The mean haemoglobin concentration was 10.78 ± 1.49 g/dl. The mean MCV was in the lower limits of normal, 79.73 ± 7.95 3FL. At a cut off haemoglobin concentration of 10.8 g/dl, 50% of the population had Haemoglobin concentrations lower than this value. In terms of mean Haemoglobin levels across Pakistan's provinces, the lowest haemoglobin level was recorded in Sind, at 10.34 ± 1.469 g/dl. It was followed by Punjab, with a mean Haemoglobin concentration of 10.8 g/dl + 1.89. However, the mean Haemoglobin concentration in KPK was significantly high with mean Hb of 11.01 ± 1.330 g/dl. Additionally, comparable Haemoglobin levels were seen in Baloch people, with a mean Hb of 10.95 ± 1.048 g/dl. So according to international standard anaemia was less prevalent in KPK and Balochistan. Conclusion: Anaemia during pregnancy is very common in Pakistani mothers, according to worldwide standards. However, Severe anaemia Hb<8g/dl, on the other hand, is uncommon. Interprovincial variation in haematological parameters is also notable in Pakistan. We may need to formulate local guidelines for diagnosing and managing anaemia.
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妊娠期贫血;一个不发达国家的视角(巴基斯坦四个省首次多中心试验)
目的:确定巴基斯坦四个省母亲贫血的真实患病率,并比较血液学参数。地点:卡拉奇医院(信得省)、哈里安医院(旁遮普)、马尔丹医院(KPK)、奎达医院(俾路支省)的多中心研究。工期:2021年4月至9月,为期6个月。研究设计:前瞻性观察性研究。方法:建立4个中心,对每个省的代表性样本进行数据收集。与血液学测量一起,获得社会人口统计数据并将其放入预定义的在线形式中。采用SPSS v 20软件对数据进行分析。对分类变量计算频率和百分比,而用均值和标准差表示尺度。分析比较了四省调查结果的异同。结果:符合纳入标准的女性患者共2060例,来自所有4个省:2022年产科妇科研究;5 (1): 034-040 DOI: 10.26502/ogr076妇产科研究卷5 No. 1 - 2022年3月。35人被纳入研究。460人(22%)处于妊娠早期,785人(38%)处于妊娠中期,815人(40%)处于妊娠晚期。研究人群的平均年龄为28±5.033岁。平均血红蛋白浓度为10.78±1.49 g/dl。平均MCV为79.73±7.95 3FL,处于正常的下限。在血红蛋白浓度为10.8 g/dl的临界值下,50%的人群血红蛋白浓度低于此值。就巴基斯坦各省的平均血红蛋白水平而言,最低的血红蛋白水平记录在信德省,为10.34±1.469 g/dl。其次是旁遮普,平均血红蛋白浓度为10.8 g/dl + 1.89。然而,KPK的平均血红蛋白浓度显著高,平均Hb为11.01±1.330 g/dl。此外,俾路支人的血红蛋白水平相当,平均Hb为10.95±1.048 g/dl。因此,根据国际标准,贫血病在KPK和俾路支省不那么普遍。结论:根据国际标准,妊娠期贫血在巴基斯坦母亲中非常普遍。然而,另一方面,严重贫血Hb<8g/dl是罕见的。在巴基斯坦,血液学参数的省际差异也很显著。我们可能需要制定诊断和管理贫血的当地指南。
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