Detection of Anemia Among Pregnant and Non-pregnant Saudi Women in El-Khurmah Province in Saudi Arabia (2012)- Comparative Study

Abstract

This study was hospital analytical, descriptive and cross-sectional conducted to determine the type of anemia in pregnant and non-pregnant Saudi women in EL- Khurmah province in Western of Saudi Arabia in the period of August 2012 to august 2014. Six hundred subjects were informed about the study and agreement for participation was obtained. Study group was divided as follow: fifty healthy non-pregnant women a control, two hundred and fifty non-pregnant women, one hundred and fifty pregnant women with prophylactic iron therapy and one hundred and fifty of non-pregnant women without prophylactic iron therapy. A venous blood of five ml was collected, 2.5ml in EDTA containers and investigated for a complete blood count (CBC), Reticulocyte count (Retics count) and hemoglobin electrophoresis. The other volume of blood was collected to obtained serum for biochemical tests, including; serum iron, serum ferritin and total iron binding capacity. Fully automated hematological analyzer (Cell Dyn 1700), Electrophoresis tank and power pack were used for analysis and Statistical Package for Social Sciences (SPSS). The mean age of the subjects was (32±4.35 year) for non-pregnant women and (29.6±4.48 year) for pregnant women. The mean of hematological and biochemical parameters of control group, non-pregnant women , pregnant women with iron therapy and pregnant women without iron therapy as follow : total erythrocyte count were 4.28±0.25, 4.18±0.35, 4.21±0.353, 3.81±0.48 respectively. Hemoglobin concentration were 12.97±0.4, 11.8±1.02, 10.9±1.2, 9.8±0.99 respectively .Hematocrit (Hct) 38.8%, 35.4±3.9%, 33.3±2.9%, 29.9±3.5 % respectively. Mean cell volume (MCV) 90.7±5.2, 83.2±9.2, 83.1±7.5, 75.4±8.5 respectively. mean cell hemoglobin (MCH) 30.2±1.6,27.8±3.1,31.2±2.6,24.3±3.2 respectively. mean cell hemoglobin concentration (MCHC) 33.4±0.47,31.6±2.5,31.1±2.1,24.3±3.2 respectively. V reticulocyte count 1.1±0.11 %,1.1±0.1 %,2.5±1.7 %,0.5±0.3 % respectively .serum iron 91.9±8.6 ,80±14.4 ,68.7±15.6,61.1±7.53 respectively. Serum ferritin 49.5±9.0, 19.5±9.3, 14.08±2.683, 10.53±1.945 respectively. Total iron binding capacity (TIBC) 302±14.5, 325±53.6, 370±21.90, 377±35.9 respectively. And transferrin saturation (TS %) 30±2.6 %, 25.2±.114%, 18.6±4.44 %, 16.3±2.889 respectively. The hematological and biochemical parameter were compared with that of non-pregnant women, pregnant women with iron therapy, and pregnant women without iron therapy .it were all increased in control group against others groups except in the mean of total erythrocyte count there was no difference between control group, non-pregnant women, and pregnant women with iron therapy. Also the mean of reticulocyte count decreased in control group against that of pregnant women with iron therapy and same mean in pregnant women without iron therapy. The hematological parameters among non-pregnant women was compared with that of pregnant women with prophylactic iron therapy and pregnant women without prophylactic iron therapy , the mean hemoglobin level , hematocrit were increased in non-pregnant women compared with pregnant women with prophylactic iron therapy (p < 0.061),( p < 0.077) . but there was no difference in the mean of total erythrocyte count , mean cell volume , and mean cell hemoglobin concentration ( p < 0.055),( p < 0.051) ,( p < 0.053) respectively . The mean of red mean hemoglobin concentration and reticulocyte count in pregnant women with prophylactic iron therapy was increased than that of non-pregnant women (p<0.06) (p<0.004) respectively. In other side the mean of (RBC), (Hb), (Hct) ,(MCV) ,(MCH) , (MCHC) and reticulocyte count was decreased in pregnant women without iron therapy when compared with that of non-pregnant women and pregnant women with prophylactic iron therapy (p< 0.065) (p<0.055) , (p<0.06) (p<0.001),(p< 0.006) (0.07), (p<0.004) , (0.005) ,(p<0.007) (0.005),(0.053) (0.05) and (0.0)(0.001) respectively and the mean of reticulocyte count was increased in pregnant VI women with prophylactic iron therapy when compared with that of non-pregnant women and pregnant women without prophylactic iron therapy (p < 0.004)( p < 0.001) respectively. Blood film examination indicated that (73.2%) , (68.6%) and (78.6%) of non-pregnant women ,pregnant women with prophylactic iron therapy , and pregnant women without prophylactic iron therapy respectively. No abnormal hemoglobin pattern was found in our study group. (All groups were adult Hemoglobin pattern, HbA2 was not found). The biochemical results including serum iron, serum ferritin, and TS%, were increased in control group when compared with other groups, but we observed that TIBC% was decreased. It was showed variable results in other study group , the mean of serum iron of non-pregnant women was increased than that of pregnant women with prophylactic iron therapy and pregnant women without prophylactic iron therapy (p<0.001),(p<0.006) respectively. And it was increased in pregnant women with prophylactic iron therapy when compared with that of pregnant women without iron therapy (p<0.065).The mean of total iron binding capacity (TIBC) showed no difference in subjects groups. (p<0.05), (p<0.07) and (p<0.07). According to trimester in pregnant women with iron therapy the frequency of anemia in first trimester, second trimester, and third trimester were 4.70%, 36.47% and 58.8 % respectively.in other side the frequency of anemia in pregnant women without iron therapy were 31.5%,33.20% and 35.3 % respectively. As for spacing the highest percentage of iron deficiency anemia was found among pregnant women whom had spacing of less than one year and up to one year 43.3% the lowest percentage was observed among those spacing was more than two years 24.6%. The results above showed that the only type of anemia was iron deficiency anemia. The frequency of iron deficiency anemia among non-pregnant, pregnant women with prophylactic iron therapy and pregnant women without prophylactic iron therapy were (47.2%), (56.6%) and (77.3%) respectively. The percentage of iron deficiency anemia VII decreased in pregnant women whom take iron therapy and dimorphic blood picture was noted in thin blood film of them. Percentage of iron deficiency anemia was increased in women that take a lot of Saudi coffee, chawing ice and skip breakfast meal .also the percentage was high in women whom had birth space less than one year up to one year.