Haemato-biochemical indices and their correlation with obstetrics profile and complications among pregnant women in the Northern Region of Ghana

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Pregnancy is a physiological condition in which the body undergoes extensive systemic alterations and modifications to compensate for the demands of the growing fe|tus. Howe|ve|r, obste|trics practice| in Africa of which Ghana is not an e|xception; is marred by a lot of challenges and complications. Anaemia and spontaneous abortion are among the leading frontiers of pregnancy related complications. In a cross-se|ctional study to assess the| Haemato-Biochemical indices and its correlate with obstetrics profile and complications among pregnant women in Ghana, a total of 248 pre|gnant wome|n atte|nding ante|natal clinic at the| Tamale| Te|aching Hospital (T.T.H) we|re| assesed for this study. Comple|te| haemogram, immunological analysis, biochemical analysis, estimation of gestation age| using symphysiofundal height measurement,last normal menstrual period (LNMP) , re|sults from the| first trime|ste|r ultrasound scan, parasitology analysis, serological analysis and obstetrics history such as level of parity, gravidae, history of abortion (spontaneous or induce|d) we|re| re|trie|ve|d from the|ir ante|natal bookle|t. Pre|vale|nce| of spontane|ous abortion among pregnant women in Ghana as shown in this study was 65.72%. High serum folic acid levels were found to be associated with spontaneous abortion. G6PD partial de|fe|ct (OR= 0.447; 95%CI=0.208-0.961; p=0.039), Multi-parity (OR= 2.724; 95%CI=1.277-5.809; p=0.01) and irregular antenatal attendance (OR= 2.036; 95%CI=1.093-3.793; p=0.025) were risk factors for the occurrence of spontaneous abortion. The| pre|vale|nce| of anae|mia among the| pre|gnant wome|n we|re| 33.87% using (Hb<11g/dl) and 43.55% using (hematocrit<33%) as criteria. Iron deficiency (ID) and iron deficiency anaemia (IDA) were the most prevalent type| of anae|mia. The| pre|vale|nce| of iron de|ficie|ncy (ID) and iron de|ficie|ncy anae|mia (IDA) in this current study were 16.94% and 4.44% re|spectively using the conventional markers of assessing iron status. With the introduction of the modern indicators of ID and IDA, pre|vale|nce| of iron de|ficie|ncy and iron iv deficiency anaemia were 50% and 16.13% respe|tively using transferrin:log ferritin as a marker. When transferrin re|ce|ptor was use|d as an inde|x for the| asse|ssme|nt of iron status, 77.42% and 27.8% pre|vale|nce| was obtaine|d for ID and IDA re|spectively. Low ferritin concentration, advanced gestational age(2nd and 3rd trimesters), non-intake of haematinics and poor appetite for food (anorexia) were the predisposing factors for the development of anaemia in pre|gnancy. The|re| is the| need for the introduction of the| mode|rn marke|rs of assessing iron status which are not influenced by inflammation or diurnal variabilities to augment the conventional markers in our clinical practice| since| ID and IDA are| be|ing unde|rdiagnose|d. Policy on folic acid and hematinic supplementation should be urgently and critically reviewe|d in obstetrics practice|.
Thesis submitted to the Department of Molecular Medicine, School of Medical Sciences in partial fulfilment of the requirements for the Award of Master of Philosophy,