The New Indian Journal of OBGYN. Epub Ahead of Print

Prevalence of various types of anemia and thalassemia in pregnant women: experience from Northern India

Rajesh Kumar Mishra, Ajay Nathan, SD Poddar, Swati Sagarika Panda

ABSTRACT

Objectives: Anemia amounts to a significant health problem in developing countries especially among pregnant women. The present study was carried out to determine prevalence of various types of anaemia and thalassemia in antenatal women. We evaluated various discriminant indices used in diagnosis of beta thalassemia trait. Methods: A prospective observational study was carried out among antenatal women in a peripheral hospital. All women with haemoglobin <11 g/dl presenting in first trimester of pregnancy were included in the study. Complete blood count including red cell indices were measured and peripheral blood smear was examined. Blood sample was processed for serum iron studies and HPLC. Results: Anaemia was detected among 360 patients out of 928 women. More than half of the study population (58.8%) had mild anemia and severe anaemia was seen among 5.55% of patients. Iron deficiency anemia was the most common type of anemia (74.44%) followed by megaloblastic anemia. Hemoglobinopathy was seen in19 cases out of 360 patients. Our study found that no RBC index had 100% sensitivity and specificity. Green and King index had the maximum accuracy in diagnosing beta thalassemia trait followed by Sirdah index and RDW index. Conclusion: The prevalence of haemoglobinopathy in our study was 5.27%.The accuracy of various RBC indices is questionable in prediction of thalassemia trait. The diagnosis of thalassemia should rely on definitive tests like HPLC or hemoglobin electrophoresis. Universal screening of pregnant women for thalassemia should be incorporated as a national health program to prevent associated morbidity and mortality.