Hematological Profile and Blood-Borne Virus Prevalence in Pregnant Women at a Tertiary Military Hospital, Lagos, Nigeria.

Main Article Content

Sunday Isaac Omisakin
G. S. Ogoh
S. A. Ayeni
Aloy Okechukwu Ugwu
Chinenye Odo
Ugochi Chinenye Okorafor
Sunusi Rimi Garba
Oluwakemi Elizabeth Otokiti
Nkechinyere Harrison
Adebayo Williams Awoniyi
Ijeoma C. Ohagwu
Simeon Ige
D. C. Ezeoke
Monday Akpan
Austin C. Okoro
Abigail Oghenefejiro Asini
Kayode Ayodeji Adefemi
Peter Chibuzor Oriji
Kehinde S. Okunade

Keywords

Anaemia, Haematological indices, Blood-borne viruses, Pregnancy , Haemoglobinopathies.

Abstract

Background: Maternal haematological status and concurrent blood-borne viral infections play a crucial role in determining pregnancy outcomes. This study assessed haematological profiles and the prevalence of blood-borne viruses among pregnant women attending a tertiary military hospital over a four-year period.


Methodology: A retrospective cohort analysis was conducted using clinical records of 499 pregnant women who attended antenatal care at the 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Data on demographics, complete blood count, and serology for blood-borne viruses were extracted into a structured proforma. It was analysed using statistical package of social sciences (SPSS) version 29. Descriptive statistics were presented using tables and charts. Associations were tested, with statistical significance set at p<0.05.


Results: Participants had a mean age of 36 ± 2.3 years. Blood group O was most common 245(49.7%), with the least being AB blood group which accounted for 48(9.6%). Haematocrit was lowest in the third trimester (31.21 ± 4.1%, p<0.001), while 1st and 2nd trimester haematocrits were 33.49±3.4 and 31.73±3.1 respectively. Anaemia was significantly associated with primiparity (p=0.04), HIV infection (p=0.03), and the Hb AS genotype (p=0.01). HIV prevalence was 30 (6.0%) higher than that of hepatitis B 27(5.4%) and Hepatitis C 7(1.4%).


Conclusion: HIV prevalence (6.0%) was higher than hepatitis B and C, and primiparous women showed significant anaemia with low haematocrit values. These findings call for targeted nutritional support and strengthened antenatal screening for blood-borne viruses to improve maternal and fetal outcomes.

Abstract 24 | PDF Downloads 9 EPUB Downloads 9

References

1. Kadas, A. S., Okon, K. O., Chama, C., Alkali, M., Jibrin, Y. B., Balogun, S. T., Baffa, M. A., Dattijo, L. M., & Shehu, A. (2020). Haematological Profile of Pregnant Women Attending Antenatal Clinic in Bauchi, Nigeria. Open Journal of Obstetrics and Gynecology, 10(12), 1776–1787. https://doi.org/10.4236/ojog.2020.10120160

2. Mba, C. O., Jacob, R. B., Green, M. B., & Zebedee, L. U. (2019). Hematological Profile of Pregnant Women in Port Harcourt, Nigeria. International Journal of Translational Medical Research and Public Health, 3(1), 1–10. https://doi.org/10.21106/ijtmrph.63

3. Morton A. Physiological Changes and Cardiovascular Investigations in Pregnancy. Heart Lung Circ 2021; 30: e6.

4. Agarwal AM, Rets A. Laboratory approach to investigation of anemia in pregnancy. Int J Lab Hematol2021; 43 Suppl 1:65.

5. Okunade, K.S., Olowoselu, F.O., Oyedeji, O.A. et al. Prevalence and determinants of moderate-to-severe anaemia in the third trimester of pregnancy: a multicenter cross-sectional study in Lagos, Nigeria. Sci Rep 14, 11411 (2024). https://doi.org/10.1038/s41598-024-61487-4

6. Ugwu AO, Makwe CC, Oluwole AA, et al. Seroprevalence of Hepatitis B, and C Viruses and HIV Infections among Antenatal Women in a Secondary Health Facility in Lagos, Nigeria. West Afr J Med. 2022;39(10):1084-1088.PMID: 36260916

7. Eleje GU, Onubogu CU, Fiebai PO, et al. Mother-to-child transmission of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women with single, dual or triplex infections of human immunodeficiency virus, hepatitis B virus and hepatitis C virus in Nigeria: A systematic review and meta-analysis. SAGE Open Med. 2022;10:20503121221095411. Published 2022 Apr 28. doi:10.1177/20503121221095411

8. Yu W, Hu X, Cao B. Viral Infections During Pregnancy: The Big Challenge Threatening Maternal and Fetal Health. Matern Fetal Med. 2021 Dec 9;4(1):72-86. doi: 10.1097/FM9.0000000000000133. PMID: 35187500; PMCID: PMC8843053.

9. Abu-Raya B, Michalski C, Sadarangani M, Lavoie PM. Maternal Immunological Adaptation During Normal Pregnancy. Front Immunol. 2020;11:575197. Published 2020 Oct 7. doi:10.3389/fimmu.2020.575197

10. Iqbal, M., Farzand, A., Ahmad, I., Iqbal, S., & Mubeen, A. (2022). Comparative Study of Hematological Profile Variation in Three Trimesters of Pregnancy. Pakistan BioMedical Journal, 23–27. https://doi.org/10.54393/pbmj.v5i10.807

11. Uccella S, Dottermusch M, Erickson L, Warmbier J, Montone K, Saeger W. Inflammatory and Infectious Disorders in Endocrine Pathology. EndocrPathol. 2023 Dec;34(4):406-436. doi: 10.1007/s12022-023-09771-3. Epub 2023 May 20. PMID: 37209390; PMCID: PMC10199304.

12. Rasheed, B. N. (2024). Pregnant Women’s Hematological Profile in Duhok Governorate, Iraq. Medical Journal of Babylon, 21(Suppl 1), S165–S169. https://doi.org/10.4103/mjbl.mjbl_218_23

13. Alemu A, Abebe M, Terefe B, et al. Hematological Indices of Pregnant Women at the University of Gondar Referral Hospital, Northwest Ethiopia: a Comparative Cross-Sectional Study. Clin Lab. 2019;65(8):10.7754/Clin.Lab.2019.190115. doi:10.7754/Clin.Lab.2019.190115

14. Li HY, Guo K. Blood Group Testing. Front Med (Lausanne). 2022 Feb 11;9:827619. doi: 10.3389/fmed.2022.827619. PMID: 35223922; PMCID: PMC8873177.

15. Demeke, G., Mengistu, G., Abebaw, A., Toru, M., Yigzaw, M., Shiferaw, A., Mengist, H. M., &Dilnessa, T. (2021). Effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia: Institution based prospective cohort study. PLOS ONE, 16(5), e0250990. https://doi.org/10.1371/journal.pone.0250990

16. Akinbami AA, Ajibola SO, Rabiu KA, et al. Hematological profile of normal pregnant women in Lagos, Nigeria. Int J Womens Health. 2013;5:227-232. Published 2013 May 3. doi:10.2147/IJWH.S42110

17. Shi L, Wang Y, Yang H, Duan G, Wang Y. Laboratory Abnormalities in Pregnant Women with Novel Coronavirus Disease 2019. Am J Perinatol. 2020;37(10):1070-1073. doi:10.1055/s-0040-1712181

18. Price MA, Fast PE, Mshai M, et al. Region-specific laboratory reference intervals are important: A systematic review of the data from Africa. PLOS Glob Public Health. 2022;2(11):e0000783. Published 2022 Nov 14. doi:10.1371/journal.pgph.0000783

19. Abdelmageed, E., Bahaeldin, H., Nadiah, A., Abdelbagi, A., Duria, R., &Ishag, A. (2022). Maternal and neonatal outcomes of grand multiparity in Khartoum, Sudan. African health sciences, 22(1), 164–171. https://doi.org/10.4314/ahs.v22i1.21

20. Abdelmageed E, Bahaeldin H, Nadiah A, Abdelbagi A, Duria R, Ishag A. Maternal and neonatal outcomes of grand multiparity in Khartoum, Sudan. Afr Health Sci. 2022;22(1):164-171. doi:10.4314/ahs.v22i1.21

21. Aluko, J. O., Modeste, R. R. M., Adejumo, O., & Anthea, R. (2019). Return for prenatal care and childbirth services among Nigerian women using primary health care facilities. Nursing open, 7(1), 91–99. https://doi.org/10.1002/nop2.314

22. Vargas-Hernández DA, Uscategui-Ruiz AC, De Avila J, Romero-Sánchez C. Differences in the distribution of hemoglobin variants according to the geographic regions in a Colombian population. HematolTransfus Cell Ther. 2023;45 Suppl 2(Suppl 2):S140-S147. doi:10.1016/j.htct.2022.11.012

23. Enawgaw B, Aynalem M, Melku M. Distribution of ABO and Rh-D Blood Group Antigens Among Blood Donors in the Amhara Regional State, Ethiopia. J Blood Med. 2022;13:97-104. Published 2022 Feb 24. doi:10.2147/JBM.S356425

24. Omotayo MO, Abioye AI, Kuyebi M, Eke AC. Prenatal anemia and postpartum hemorrhage risk: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2021;47(8):2565-2576. doi:10.1111/jog.14834.

25. Idemili-Aronu N, Igweonu O, Onyeneho N. Uptake of iron supplements and anemia during pregnancy in Nigeria. J Public Health (Oxf). 2022;44(1):111-120. doi:10.1093/pubmed/fdaa168.

26. Lambonmung, A., Acheampong, C. A., &Langkulsen, U. (2022). The Effects of Pregnancy: A Systematic Review of Adolescent Pregnancy in Ghana, Liberia, and Nigeria. International journal of environmental research and public health, 20(1), 605. https://doi.org/10.3390/ijerph20010605

27. Kareem, Y. O., Ameyaw, E. K., Bello, O. O., Abdus-Salam, R. A., Lawal, O. O., Obajimi, G., Alade, Y. K., &Morhason-Bello, I. O. (2022). Ecological analysis of demographic-, nutritional- and housing-related factors associated with anaemia among women of reproductive age group in Nigeria. Journal of health, population, and nutrition, 41(1), 56. https://doi.org/10.1186/s41043-022-00334-6

28. Kareem, Y. O., Abubakar, Z., Adelekan, B., Ameyaw, E. K., Gbagbo, F. Y., Goldson, E., Mueller, U., & Yaya, S. (2023). Prevalence, Trends, and Factors Associated with Teen Motherhood in Nigeria: An Analysis of the 2008-2018 Nigeria Demographic and Health Surveys. International journal of sexual health : official journal of the World Association for Sexual Health, 35(2), 248–262. https://doi.org/10.1080/19317611.2023.2189763.

29. Okunade KS, Adejimi AA, Olumodeji AM, et al. Prenatal anaemia and risk of postpartum haemorrhage: a cohort analysis of data from the Predict-PPH study. BMC Public Health. 2024;24(1):1028. Published 2024 Apr 12. doi:10.1186/s12889-024-18446-5

30. Ajepe AA, Okunade KS, Sekumade AI, et al. Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria. PLoS One. 2020;15(1):e0227965. Published 2020 Jan 23. doi:10.1371/journal.pone.0227965

31. Khetsuriani, N., Lesi, O., Desai, S., Armstrong, P. A., & Tohme, R. A. (2022). Progress Toward the Elimination of Mother-to-Child Transmission of Hepatitis B Virus - Worldwide, 2016-2021. MMWR. Morbidity and mortality weekly report, 71(30), 958–963. https://doi.org/10.15585/mmwr.mm7130a2.

32. Methazia J, Ngamasana EL, Utembe W, Ogunrombi M, Nyasulu P. An investigation of maternal anaemia among HIV infected pregnant women on antiretroviral treatment in Johannesburg, South Africa. Pan Afr Med J. 2020 Sep 25;37:93. doi: 10.11604/pamj.2020.37.93.22244. PMID: 33425126; PMCID: PMC7757230.

33. Cao, G., Wang, Y., Wu, Y., Jing, W., Liu, J., & Liu, M. (2022). Prevalence of anemia among people living with HIV: A systematic review and meta-analysis. EClinicalMedicine, 44, 101283. https://doi.org/10.1016/j.eclinm.2022.101283.

34. Khan, F. H., Khalid, A. A., Alkwai, H. M., Alshammari, R. F., Alenazi, F., Alshammari, K. F., Sogeir, E. K. A., & Batool, A. (2023). The Effect of High Parity on the Occurrence of Anaemia in Pregnant Women. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 33(12), 1400–1404. https://doi.org/10.29271/jcpsp.2023.12.1400

35. Al-Farsi, Y. M., Brooks, D. R., Werler, M. M., Cabral, H. J., Al-Shafei, M. A., & Wallenburg, H. C. (2011). Effect of high parity on occurrence of anemia in pregnancy: a cohort study. BMC pregnancy and childbirth, 11, 7. https://doi.org/10.1186/1471-2393-11-7

36. Kwak DW, Kim S, Lee SY, Kim MH, Park HJ, Han YJ, Cha DH, Kim MY, Chung JH, Park B, Ryu HM. Maternal Anemia during the First Trimester and Its Association with Psychological Health. Nutrients. 2022 Aug 25;14(17):3505. doi: 10.3390/nu14173505. PMID: 36079763; PMCID: PMC9460499.