Anaemia in Pregnancy; An Underdeveloped Country’s Perspective (The First Ever Multicentre Trial in Pakistan from all Four Provinces)
Author(s): Muhammad Irfan Khattak, Samina Naseem khattak, Shumaila Hadi, Samina Rehan Khan, Muhammad Numan Khattak, Adeela Yasmeen
Objective: To determine the true prevalence of anaemia in Pakistani mothers from all four provinces and compare the haematological parameters.
Location: Multicentre study at PNS Shifa Karachi (Sind), CMH Kharian (Punjab), CMH Mardan (KPK), CMH Quetta (Balochistan).
Duration: Apr-Sep 2021 for 6 months. Study design: prospective observational study.
Methods: Four centres were established to collect data on a representative sample of each province. Along with haematological measures, sociodemographic data were obtained and placed into a predefined online proforma. SPSS v 20 was used to analyse the data. Frequencies and percentages were calculated for categorical variables, whereas means and standard deviations were used to represent scales. Results of all four provinces were analysed and compared for similarities and differences.
Results: A total of 2060 female patients fulfilling our inclusion criteria from all four provinces were included in the study. Four hundred and sixty (22%) of the total population were in the first trimester, 785 (38%) were in the second, and 815 (40%) were in the third trimester of pregnancy. The study population's mean age was 28 ± 5.033 years. The mean haemoglobin concentration was 10.78 ± 1.49 g/dl. The mean MCV was in the lower limits of normal, 79.73 ± 7.95 3FL. At a cut off haemoglobin concentration of 10.8 g/dl, 50% of the population had Haemoglobin concentrations lower than this value. In terms of mean Haemoglobin levels across Pakistan's provinces, the lowest haemoglobin level was recorded in Sind, at 10.34 ± 1.469 g/dl. It was followed by Punjab, with a mean Haemoglobin concentration of 10.8 g/dl + 1.89. However, the mean Haemoglobin concentration in KPK was significantly high with mean Hb of 11.01 ± 1.330 g/dl. Additionally, comparable Haemoglobin levels were seen in Baloch people, with a mean Hb of 10.95 ± 1.048 g/dl. So according to international standard anaemia was less prevalent in KPK and Balochistan.
Conclusion: Anaemia during pregnancy is very common in Pakistani mothers, according to world-wide standards. However, Severe anaemia Hb<8g/dl, on the other hand, is uncommon. Interprovincial variation in haematological parameters is also notable in Pakistan. We may need to formulate local guidelines for diagnosing and managing anaemia.