Abstract
Background
Abnormal intra-pregnancy haematological variables are associated with adverse feto-maternal outcomes. However, the reference intervals (RIs) employed in sub-Saharan Africa to inform clinical decisions are generally imported. Since RIs are influenced by age, geographical location, and race, we hypothesized that context specific RIs should be established in Ghana to contextualize intra-pregnancy decision making.
Methods
This cross-sectional study retrospectively retrieved data of 333 pregnant women with no known clinically determined intra-pregnancy complications; 22 participants in their first trimester (T1; 1–13 weeks), 177 in their T2 (14–27 weeks), and 132 in T3 (28–41 weeks). RIs for haematological parameters were non-parametrically determined at 2.5th and 97.5th percentiles in accordance with CLSI guidance document EP28-A3c. Two-sample comparisons were undertaken using Wilcoxon rank-sum tests whereas more than two-sample comparisons were undertaken using Kruskal-Wallis test. Statistical significance was set at p <0.05 under the two-tailed assumptions.
Results
In accordance with WHO trimester-specific haemoglobin cutoffs, anaemia prevalence was a moderate (T1: 36.4%; 8/22 & T2: 31.6%; 56/177) to severe (T3:68.0%; 90/132) public health problem. Additionally, 9.3% (31/333) individuals had high gestational haemoglobin levels (Hb >13.0 g/dL). Moreover, haemoglobin (T2: 8.6–14.3 vs T3: 7.5–13.6 g/dL), MCH (T2: 22.5–69.8 vs T3: 21.6–31.9 pg), MCHC (T2: 30.2–51.8 g/L vs T3: 30.5–37.9 g/L), TWBC (T2: 4.0–13.4 vs T3: 4.1–13.0 x 109/L) required trimester specific RIs, compared to RBC (2.8–5.1 x 1012/L), MCV (66.2–100.2 fL), and platelet counts (106.3–388.3 x 109/L) that each required combined reference intervals.
Conclusions
The intra-pregnancy haematological RIs determined have appreciable lower limits; there is the need to determine context-specific thresholds for haematological variables predictive of positive and/or adverse maternal and infant health outcomes.
Publisher
Public Library of Science (PLoS)
Reference23 articles.
1. Reference intervals for selected haematological and biochemical parameters among apparently healthy adults in different eco-geographical zones in Ghana.;G Abbam;PLoS One,2021
2. Determination of Haematological Reference Ranges in Healthy Adults in Three Regions in Ghana;O Addai-Mensah;Biomed Res Int,2019
3. Haematological reference intervals for healthy adults in Bamenda, Cameroon.;VN Fondoh,2020
4. Haematological values in a healthy adult population in Yaoundé, Cameroon.;ME Oloume,2019
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献