Iron deficiency anaemia and beta thalassaemia trait in anaemic pregnant women

الملخص EN

Back ground : Anaemia is one of commonest health problems in antenatal care units of developing countries and contributes significantly to increased maternal and fetal morbidity and mortality.

Patients and methods : During the period from 1st of July 2007 to the end of October 2007, hundred anaemic pregnant women attending the gynaecology and obstetrics department in Al- Yarmook teaching hospital in Baghdad and 20 apparently healthy pregnant women,aged between 17-46 years as a control were included in this study.

Anaemic women included in this study fulfilled the criteria of haemoglobin concentration of less than 110 g / L in first trimester and 105g / L in the second and third trimesters, no history of acute or chronic illnesses, not receiving any treatment and without any family history of haematological disorders.

These women were randomly selected in relation to age, parity, trimester of pregnancy and social status.

Ten mls of venous blood samples were aspirated from each pregnant women in the studied group, two mls were put in ethylendiaminetetra acetic acid (EDTA) tube and analyzed for peripheral blood smear, reticulocyte count and haemoglobin A2 (Hb A2) using standard methods for hematological investigation.

While the remaining 8 ml were put in a plain tube to evaluate serum iron, total iron binding capacity and serum ferritin.

Serum iron, total iron binding capacity was done by colometric method, while serum ferritin was done by immunoenzymatic assay and hemoglobin A2 (HbA2) level by haemoglobin electrophoresis.

Results : Peripheral blood smear study revealed a hypochromic microcytic anaemia in 81 % of cases, 8 % of cases showed macrocytic anaemia, 8 % a normochromic normocytic anaemia while the remaining 3 % of cases showed a dimorphic picture .Iron deficiency anemia constitutes 79 % of the cases confirmed by serum ferritin.

Only two cases (2 %) had elevated level of HbA2.

Serum iron, total iron binding capacity and serum ferritin had significant differences in those cases with low social status, increasing parity and increasing gestational age (trimesters).Iron deficiency anaemia was not found to have a significant association with increasing age, while patients with para 4 and more, in the third trimester and low social status were more significantly affected with iron deficiency anemia.

Conclusion : Iron deficiency anemia was found in 79 % of anemic pregnant females confirmed by measurement of serum ferritin level.

There were a significant difference between parity ; social status and gestational age with the incidence of iron deficiency anemia.β-thalassaemia trait constitute only 2 % of anemic cases in the studied sample.