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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 3  |  Page : 75-78

The haematological parameters of normal pregnant women and cord blood of their newborns in Aminu Kano Teaching Hospital, Kano, Nigeria


1 Department of Haematology and Blood Transfusion, UDUTH, Sokoto, Nigeria
2 Department of Haematology and Blood Transfusion, AKTH, Kano, Nigeria
3 Department of Obstetrics and Gynaecology, AKTH, Kano, Nigeria

Date of Web Publication2-Apr-2018

Correspondence Address:
Ibrahim Abdulqadir
Department of Haematology and Blood Transfusion, UDUTH, Sokoto
Nigeria
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DOI: 10.4103/ssajm.ssajm_16_17

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  Abstract 

Context: Haematological parameters are frequently used to determine the health status of an individual, and their values are varied among different populations. Hence, there is a need for a local data repository to serve as a reference source for appropriate adoption of therapeutic interventions.
Aims: To determine the haematological parameters of normal pregnant women at term and cord blood of their newborns.
Materials and Methods: One hundred and forty normal pregnant women and their newborns were enrolled in this study. Bio-demographic and clinical data were extracted from the client folder. In addition, 4 mL of blood was obtained from pregnant women and from the cord of their newborns. Full blood count was obtained using Swelab automatic analyser, whereas reticulocyte count and erythrocyte sedimentation rate (ESR) were determined manually.
Results: The mean haematological parameters of pregnant women and their newborns respectively were as follows: haemoglobin − 11.35 ± 1.28 g/dL and 16.67 ± 1.11 g/dL; mean cell volume − 80.43 ± 7.44 fL and 109.09 ± 3.49 fL; white blood cell count (WBC) − 8.52 ± 2.06 × 109/L and 12.11 ± 1.80 × 109/L; platelet count − 247.33 ± 87.81 × 109/L and 250.06 ± 54.65 × 109/L; reticulocyte count − 1.24 ± 0.72% and 4.08 ± 0.39%; ESR − 40.74 ± 17.82 mm and 2.41 ± 1.13 mm in the first hour. There was a positive correlation between maternal and cord blood WBCs and neutrophil count (P = 0.03 and 0.02, respectively).
Conclusion: The values obtained in this study will serve as a guide for interpreting the haematological parameters of pregnant women at term and cord blood of newborns in the environment.

Keywords: Cord blood, haematological parameters, kano, normal pregnant women


How to cite this article:
Abdulqadir I, Ahmed SG, Kuliya AG, Tukur J, Yusuf AA, Ndakotsu MA. The haematological parameters of normal pregnant women and cord blood of their newborns in Aminu Kano Teaching Hospital, Kano, Nigeria. Sub-Saharan Afr J Med 2017;4:75-8

How to cite this URL:
Abdulqadir I, Ahmed SG, Kuliya AG, Tukur J, Yusuf AA, Ndakotsu MA. The haematological parameters of normal pregnant women and cord blood of their newborns in Aminu Kano Teaching Hospital, Kano, Nigeria. Sub-Saharan Afr J Med [serial online] 2017 [cited 2019 Oct 17];4:75-8. Available from: http://www.ssajm.org/text.asp?2017/4/3/75/228973




  Introduction Top


Haematological parameters are frequently used to determine the overall health status of individuals, because each component serves as an important guide to a particular disease such as anaemia, infection and haemostatic challenge.[1],[2],[3],[4] These parameters are known to vary with age, sex, race, geographic location and even special circumstances such as pregnancy. These parameters keep changing even in the same individual.[5] Among all the variations in haematological parameters, pregnant women and newborns present special situations. Normal pregnancy is accompanied by numerous changes in the maternal physiology, which are aimed at accommodating and nourishing the foetus.[6],[7] Haematological parameters reported in pregnancy such as anaemia and leucocytosis may be a reflection of the physiologic response or its exacerbation due to pathologic event like iron deficiency.[8],[9] Whatever the case, maternal haematological parameters may determine both the outcome of pregnancy and the haematological parameters of the newborn especially in the cord blood.[10],[11] Currently, studies on the haematological parameters of cord blood are gaining popularity because it reflects both foetal and maternal health during gestation and at birth, as well as because of the utility of cord blood in stem cell transplant.[12],[13]

The aim of this study was to determine the haematological parameters of normal pregnant women at term and cord blood of their newborns, as well as to determine any correlation between them.


  Materials and methods Top


This was a cross-sectional study conducted among 140 normal pregnant women at term and their newborns from October 2014 to December 2016. Participants were all consenting pregnant women who had an uneventful spontaneous vaginal delivery of a normal baby with Apgar score ≥8 at 5 min and absence of any obvious congenital abnormality at the labour ward of the Aminu Kano Teaching Hospital, Kano. Women with sickle cell disease, hypertension, and liver, renal or endocrine diseases were excluded from the study. In addition, all pregnant women who tested positive for human immunodeficiency virus (HIV) I and II antibodies or antigen, hepatitis B surface antigen and hepatitis C antibodies were excluded.

The bio-demographic and clinical data (previous obstetric history, a history of hypertension, liver, renal and endocrine diseases and the results of previous laboratory investigations) of the participants were extracted from their case folder. Four millilitres of blood was collected aseptically from the antecubital vein of the pregnant women during their admission to the labour ward. The same amount of blood was obtained from the umbilical cord of the newborns after double clamping in the standard way and cleaning the area in between the clamps with 70% ethanol followed by betadine swabs. Blood samples, which were anti-coagulated with K2-Ethylene diamine tetraacetic acid (K2-EDTA), from both mothers and newborns were processed within 4 h of collection. Full blood count was obtained using Swelab 3-part automated differential coulter, whereas reticulocyte count and erythrocyte sedimentation rate (ESR) were determined manually. Serological tests for HIV, hepatitis B and hepatitis C were performed with Determine™ HIV-1/2 Ag/Ab Combo, Ascon and Healgen, respectively.

Informed written consent was obtained from each participant, and the study was approved by the Research Ethics Committee of the hospital.

Data generated were analysed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, United States) version 16.0 software and presented as mean (± standard deviation). Association between the haematological parameters of the pregnant women and the cord blood of their newborns was determined by Pearson correlation analysis, and a P-value of <0.05 was considered significant.


  Results Top


One hundred and forty peripheral blood samples from pregnant women and 147 cord blood samples from their newborns were analysed. The mean age of the pregnant women was 28.34 ± 5.94 years, and 50.71% of them had tertiary education. Their mean systolic and diastolic blood pressures were 115.14 ± 10.32 mmHg and 66.00 ± 6.68 mmHg, respectively, and the mean birth weight of their babies was 2.91 ± 0.43 kg.

The haematological parameters of the pregnant women and their newborns, as well as the relationship between the two, are summarised in [Table 1]. A comparison between the haematological parameters of pregnant women in this study and those of non-pregnant women from other studies across the country is presented in [Table 2]. The mean haematological parameters of pregnant women and their newborns respectively were as follows: haemoglobin − 11.35 ± 1.28 g/dL and 16.67 ± 1.11 g/dL, platelet count − 247.33 ± 87.81 × 109/L and 250.06 ± 54.65 × 109/L, white blood cell count (WBC) − 8.52 ± 2.06 × 109/L and 12.11 ± 1.80 × 109/L and reticulocyte count − 1.24 ± 0.72% and 4.08 ± 0.39%. WBC and neutrophil count showed a significant but weak positive correlation between cord blood and the corresponding maternal parameters.
Table 1: Haematological parameters of pregnant women and cord blood of their newborns as well as correlation between the two

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Table 2: Comparison between the haematological parameters of pregnant women in this study and those of non-pregnant women as reported by other studies[14],[15]]

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  Discussion Top


The haematocrit, haemoglobin concentration and red cell count of the pregnant women in this study were significantly lower than that reported among their non-pregnant counterparts.[14],[15] However, they were in keeping with the findings of other studies among pregnant women.[16],[17] These low values of red cell related parameters among normal pregnant women could be due to increased susceptibility to infections such as malaria, haematinics related (deficiency or inadequate intake) or as a result of physiological anaemia that arises during pregnancy. All the participants in the study were given prescriptions for haematinics (iron and folic acid) and intermittent prevention therapy for malaria according to antenatal care protocol. They were also counselled regarding compliance with routine drugs during each antenatal care visit. Although neither their level of compliance with routine drugs nor the serum level of these drugs were determined, this low value of red cell related parameters may be ascribed to physiological anaemia that arises during pregnancy. In spite the increased serum levels of thyroid hormone and erythropoietin during pregnancy and the role of these hormones in stimulating erythropoiesis, physiological anaemia during pregnancy ensues.[18],[19] Physiological anaemia during pregnancy is mainly because of a higher increase in plasma volume than red cell mass secondary to sodium retention.[16] This is mediated through aldosterone–renin–angiotensin pathway activated by progesterone and oestrogen secreted by the placenta.[16] The combination of anaemia, increased plasma volume and proteins (fibrinogen and factor VIII), susceptibility to infections, hormonal changes and iron deficiency associated with pregnancy may contribute to the resultant higher ESR value during pregnancy as seen in this study.[18]

The red cell distribution width (RDW), mean cell volume (MCV), reticulocyte count, platelet count, total white cell count and differentials of the pregnant women in the study were within normal limits for the age- and sex-matched adults. In addition, the values were similar to those reported from other parts of the country.[16],[17],[20] Although pregnancy may be associated with neutrophilia due to placental G-CSF and thrombocytopenia due to incidental thrombocytopenia during pregnancy, our findings imply that pregnancy may have an insignificant role on the outcome of these parameters among women in this environment.

The cord blood haematocrit, haemoglobin concentration and red cell count of newborns in this study were higher than that reported by Adewumi et al. in Lagos (44.00 ± 5.73%, 13.29 ± 1.50 g/dL and 4.07 ± 0.55 × 1012/L, respectively) and by Al-Marzoki et al. in Iraq (44.42 ± 4.74%, 13.76 ± 1.46 and 4.00 ± 0.47 × 1012/L, respectively).[20],[21] However, our values were in keeping with the findings of several other studies.[11],[17] This difference could be related to the timing of cord clamping, maternal parameters or possibly some geographical factors such as altitude. The relative intrauterine hypoxia due to high affinity foetal haemoglobin and low 2,3DPG levels in utero can cause increased red cell production to meet up with tissue perfusion and consequently accounting for these high values seen at birth.[22] These high values can be accentuated in the presence of asphyxia from any cause. The reticulocytosis seen among newborns in our study was similar to the finding (reticulocyte count 5.5 ± 0.86%) of Elgari et al. and may be due to bone marrow response to intrauterine hypoxia.[23]

Our findings in terms of MCV, RDW, platelet count, white cell count, neutrophil count and lymphocytes count among newborns were similar to the values reported by Adewumi et al. and others.[21],[23],[24] The total white blood cell count and its differentials continue to show variation at every stage of an individual’s life, with leucocytosis and neutrophilia noticeable at birth even in the absence of infection.[22] However, the range of platelet count in a newborn is within the range of an adult and is the only haematological parameter that remains relatively stable from neonatal stage until old age under similar physiological conditions.[22]

The absence of a comparison with non-pregnant women in the same environment was an important limitation to this study. However, such a group will not provide data needed to balance the study, because the study assessed the haematological parameters of the cord blood in addition to those in normal pregnant women.

The findings of this study highlighted the need for reference data of each population and taking cognisance of the same while interpreting the haematological parameters of that population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Chaudhari SJ, Bodat RK. Are there any difference in haematological parameters in pregnant and non-pregnant women? Natl J Community Med 2015;6:429-32.  Back to cited text no. 7
    
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Pol RR, Pattar R, Anilraj XX, Yelamali BC, Badakali A. Haematological parameters for early assessment of severity of birth asphyxia. IJCMAAS 2015;7:92-3.  Back to cited text no. 12
    
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Isa AH, Hassan A, Garba Y, Ijei IP. Reference ranges of some haematological parameters in healthy Northern Nigerian adults. Jos J Med 2012;6:16-8.  Back to cited text no. 14
    
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Dashe TM, Osawe S, Tokdung M, Daniel N, Choji RP, Mamman I et al. Comprehensive reference ranges for haematology and clinical chemistry laboratory parameters derived from normal Nigerian adults. PLoS One 2014;9:e93919. doi: 10.1371/journal.pone.0093919  Back to cited text no. 15
    
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Akinbami AA, Ajibola SO, Rabiu KA, Adewunmi AA, Dosunmu AO, Adediran A et al. Haematological profile of normal pregnant women in Lagos, Nigeria. IJWH 2013;5:227-32.  Back to cited text no. 16
    
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Mwinga K, Vermund SH, Chen YQ, Mwatha A, Read JS, Uransa W et al. Selected haematological and biochemical measurements in African HIV infected and uninfected pregnant women and their infants: The HIV prevention trial network 024 protocol. BMC Paediatr 2009;9:49. doi: 10.1186/1471-2431- 9-49.  Back to cited text no. 17
    
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Mims MP, Prchal JT. Hematology during pregnancy. In: Kaushansky K, Lichtman MA, Beutler E, Kipps TJ, Seligsohn U, Prchal JT, editors. Williams Hematology. 8th ed. China: McGraw-Hill Companies, Inc.; 2010.  Back to cited text no. 18
    
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Zimmerman MB, Burgi H, Hurrel RF. Iron deficiency predicts poor maternal thyroid status during pregnancy. J Clin Endocrinol Metab 2007;92:3436-40.  Back to cited text no. 19
    
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  [Full text]  
21.
Adewumi A, Titilope A, Akinsegun AA, Abidoye G, Ebele U, Sulaimon AA. Cord blood full blood count parameters in Lagos, Nigeria. PAMJ 2014;17:192. doi: 10.11604/Pamj.2014.17.192.3680  Back to cited text no. 21
    
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Palis J, Segel GB. Hematology of the fetus and newborn. In: Kaushansky K, Lichtman MA, Beutler E, Kipps TJ, Seligsohn U, Prchal JT, editors. Williams Hematology. 8th ed. China: McGraw-Hill Companies, Inc.; 2010.  Back to cited text no. 22
    
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Elgari MM, Waggiallah HA. Assessment of haematological parameters of neonatal cord blood in anaemic and non anaemic mothers. J Clin Exp Res 2013;1:22-5.  Back to cited text no. 23
    
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Al-marzoki JM, Al-maaroof ZW, Kadhum AH. Determination of reference ranges for full blood count parameters in neonatal cord plasma in Hilla, Babil, Iraq. J Blood Med 2013;3:113-8.  Back to cited text no. 24
    



 
 
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