Prevalence of hemolytic anemia and hemoglobinopathies among the pregnant women attending a tertiary hospital in central India

Abstract

Anemia in pregnancy is one of the causes of maternal morbidity and, maternal and fetal mortality in India. Hemoglobin transports oxygen to different parts of the body. Any defect in hemoglobin structure leads to its adverse functions. Screening of pregnant women for hemoglobinopahties helps in early intervention for reducing morbidity and mortality. Although the prevalence of hemoglobinopathies especially of the sickle cell disorders is high in Madhya Pradesh but any study on pregnant women is lacking. This study had set the objectives to find the prevalence of anemia and hemoglobin disorders in pregnant women, and to determine the health status through hematological indices profile in central India. Hospital based a cross-sectional study showed 12.26% prevalence of hemoglobinopathies among 416 pregnant women, the sickle cell trait being 7.45%, followed by β-thalassemia trait (2.89%), hemoglobin E trait (0.24%), and sickle cell disease (1.68%). About 88% of the pregnant women were found free of hemoglobinopathies. Of the 9.13% pregnant women included in the study were suffering from sickle cell disorders. However, the overall 47.11% anemia was observed in pregnant women, ranging in between 45% to 66% and seemed to show a reduction in anemia after nutritional supplementations and improvement in maternal health care at antenatal check up due to accessibility to medical health facilities. A comparison of hematological indices of pregnant women afflicted with and without sickle cell disorders have revealed much reduced hemoglobin level, red blood cells count, mean corpuscular volume, hematocrit, and mean corpuscular hemoglobin; and raised leucocytosis in sickle cell disorder cases than among the normal pregnant women. A more vigorous and realistic campaign of prophylactic regime of supplementations for these pregnant women and child health care is suggested. 妊娠期贫血是印度产妇母体发病率以及母婴死亡率的原因之一。 血红蛋白将氧输送到身体的不同部位。 血红蛋白结构的任何缺陷都导致其功能不良。 孕妇的血红蛋白病筛查有助于早期干预，降低发病率和死亡率。 虽然血红蛋白病特别是镰状细胞病的患病率在中央邦较高，但对孕妇的任何研究都很缺乏。 本研究将目标设为找出孕妇贫血和血红蛋白病患病率，并通过印度中部的血液指标情况来确定健康状况。 医院基于一项横断面研究显示了416名孕妇中12.26%的血红蛋白病患病率，镰状细胞特征为7.45%，接下来是β地中海贫血特征（2.89%）、血红蛋白E特征（0.24%）和镰状细胞病（1.68%）。 约88%的孕妇被发现未患血红蛋白病。 纳入研究的孕妇有9.13%患有镰状细胞病。 然而，在孕妇中观察到总体47.11%的贫血，范围从45%到66%之间，在营养补充以及由于医疗卫生设施可及性原因在产前检查时孕妇健康护理改善后，看来显示出贫血的减少。 对患有或未患镰状细胞病的孕妇血液学指数的比较揭示出，镰状细胞症病的病例与正常孕妇相比血红蛋白水平、红细胞计数、平均红细胞容积、血细胞比容和平均红细胞血红蛋白有很大降低，以及有白细胞的增多。 建议对于这些孕妇和儿童的卫生护理的预防性补充方案采取更积极并且更切实际的活动。