Biochemical and haematological profiles of anaemic pregnant women attending antenatal clinic at the Bolgatanga Regional Hospital, Ghana.

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Anaemia in pregnancy is a major public health problem associated with maternal morbidity and mortality, especially in developing countries. It is important that there should be a firm diagnosis of anaemia to unravel its possible cause(s) before the prescription of an appropriate therapeutic approach. The use of haemoglobin (HGB) level alone appears insufficient in determining the status of anaemia in pregnancy. It is hypothesised that a combination of biochemical and haematological parameters could enhance the diagnosis. A cross-sectional study was conducted among pregnant women attending their first antenatal visit at the Bolgatanga Regional Hospital Antenatal Clinic. Using a structured questionnaire, the socio-demographic data of the women were obtained. Venous blood was collected for haematological and biochemical analyses. Haematological parameters such as haemoglobin electrophoresis, white blood cells (WBCs), haemoglobin (HGB), haematocrit (HCT), red cell distribution width (RDW), mean cell haemoglobin concentration (MCHC), mean corpuscular volume (MCV) were determined. The biochemical parameters determined included ferritin, serum iron, total iron binding capacity (TIBC), transferrin saturation (TfS), C-Reactive Protein (CRP), bilirubin, etc. Also, thick blood films were prepared for malaria parasite identification, while early morning stool and midstream urine samples were used for the determination of enteric and urogenital parasites, respectively. It was found that younger age in pregnant women (<30 years) increased the risk of anaemia, with an odds ratio of 1.677(1.081-2.600). The study also found a significant association (p<0.05) between parity, gravidity and anaemia in pregnancy. Rural dwelling, and environmental factors such as source of drinking water (borehole, well) and presence of domestic animals also contributed to anaemia in pregnancy, (p-value<0.05). Considering the biochemical parameters, it iv was observed that serum iron and transferrin saturation had a significant association with anaemia in pregnancy; p-value<0.05. There was no significant difference (p-value>0.05) with regards to haemoglobinopathies and parasitic infections in the two groups of pregnant women. This study has succeeded in the advocacy for investigating the cause of anaemia before blindly treating patients with haematinics.
A thesis submitted to the Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirement for the Degree of Master of Philosophy in Biochemistry, 2015