SOURCE:

Faculty: Health Sciences And Technology
Department: Medical Laboratory Science

CONTRIBUTORS:

Aloy-Amadi, O. C.
Amilo, G. I.

ABSTRACT:

Normal pregnancy is characterized by changes in haematological and immunological parameters which have been linked to physiologic adaptation. Some of these changes may be adverse while others are beneficial in pregnancy.The immunological and haematological parameters of apparently healthy pregnant women attending the antenatal clinics at NAUTH, Nnewi, Anambra state were evaluated to ascertain the levels of Cluster of differentiation four(CD4+) cell count, Interleukin(IL)- IL-2, IL-4, IL-10, Tumor Necrosis Factor Alpha (TNF–α), serum Ferritin, serum iron, Mean Cell Volume (MCV), Mean Cell Haemoglobin (MCH), Mean Cell Haemoglobin Concentration (MCHC), Prothrombin Time (PT), Activated Partial Thromboplastin Time in pregnant women and non- pregnant women. One hundred and sixty (160) apparently healthy pregnant women aged 20 – 40 years, of which 140 completed the study and 160 age-matched non –pregnant women were sampled using a haematology autoanalyser to assess haematological parameters. The Enzyme - linked immunosorbent (ELISA) technique was used to analyze serum ferritin and cytokines, Serum iron was analysed using the spectrophotometric method, PT and APTT were analysed using Dia – PT and APTT test kits, while Partec cyflow counter was used to analyse CD4+ cell count. The thin blood film was used to report the morphology of blood cells. The CD4+ cell count (cells/µl) in the first (660.12 ± 484.92), second (625.45 ±160.17), and third (621.92 ±159.40) trimesters were significantly decreased compared to non-pregnant controls (764.27 ± 182.58) (F = 11.3, p < 0.001). IL – 2 (pg/ml) in the first (52.18 ± 31.70), second (48.58 ±31.01), and third (46.82 ± 31.13) trimesters showed a significant decrease when compared to controls (56.17 ±31.45) (F = 3.6, p = 0.014). TNF-α (ng/l) showed no significant decrease when the first (168.97±126.33), second (166.69 ± 67. 43), and third (165.95 ± 68.97) trimesters were compared to the controls (169.27 ±56.63) (F = 0.1, p = 0.972). There was a significant increase when IL - 4 (pg/ml) in the first (28.12 ±17.38), second (31.33 ± 17.51), and third (33.81 ± 17.78) trimesters, were compared to controls (27.73 ± 21.68) (F = 4.8, p = 0.002). A significant increase was also observed when IL – 10 (pg/ml) in the first (30.54 ± 13.10), second (34.54 ± 16.41) and third (38.66 ± 22.89) trimesters were compared to the controls (26.62 ± 17.61) (F = 17.2, p < 0.001).The MCHC (g/dl) in the first (34.56 ±1.65), second (34.57 ±1.39) and third (33.79 ± 1.65) trimesters were significantly decreased compared to the controls (35. 92 ± 1.90) (F = 57.9, p < 0.001). The PT (secs) in the first (12.86 ± 1.29), second (11.74 ±1.41), and third (10.96 ± 1.50) trimesters were significantly shortened compared to controls (14.68 ± 1.07) (F = 300.9, p < 0.001).Similarly, the APTT (secs) in the first (30.10 ± 4.54), second (29.33 ± 4.54) and third (28.33 ± 4.76) trimesters were significantly shortened compared to the controls (32.09 ± 4.72) (F = 28.33, p < 0.001). The blood films of some of the pregnant women with severe anaemia showed anisocytosis, hypochromasia,target cells, tear drop cells and microcytes. In conclusion, the findings have shown that haematological and immunological parameters alter in pregnancy. Therefore, there is need to monitor and follow up pregnancies at risk, to prevent adverse outcomes.