SOURCE:

Faculty: Health Sciences And Technology
Department: Medical Laboratory Science

CONTRIBUTORS:

Igwilo, Anastecia Chika
Amilo, G. I.
Ifeanyichukwu, M.

ABSTRACT:

In developing countries, deficiencies in macro and essential micronutrients are common, particularly in pregnant women resulting in poor pregnancy outcomes. Although, some indicators of nutrition are useful to assess nutritional status, few studies have examined such indicators throughout pregnancy in women. This study was aimed at determining the nutritional status of pregnant women across the trimesters using vitamin B12, folate and iron levels, and some haematologic parameters. The objectives were to determine the levels of total protein, albumin, vitamin B12, folate, iron, ferritin, unsaturated iron binding capacity (UIBC), serum transferrin receptors (sTfR), total iron binding capacity (TIBC) and some haematologic parameters in pregnant women attending antenatal care at the University of Calabar Teaching Hospital, (UCTH), Calabar. The study was a longitudinal study involving 72 pregnant women aged 18 to 45 years. Fifty non-pregnant women, age matched and parity, served as control. Questionnaires were completed to determine the demographic characteristics of the participants. Five milliliters of venous blood was collected from the participants during the 10, 24 and 36 weeks of gestation, representing the 1st, 2nd and 3rd trimesters respectively. The serum sample was used to determine total protein, albumin, serum iron, and unsaturated iron binding capacity using colorimetric method. Ferritin, folate, sTfR, vitamin B12 were determined using enzyme-linked immunosorbent assay (ELISA). Total iron binding capacity (TIBC) and transferrin saturation were obtained through calculations. The body mass index of the participants was calculated during the trimesters. Full blood count was carried out using Sysmex KX-21N analyzer. Analysis of variance (ANOVA) was used to compare mean values across the three trimesters, and post-hoc analyses were performed thereafter. Student’s t-test was used for two group patterns comparison and Pearson correlation was used to determine the relationships between continuous variables.The results showed that total protein, albumin and ferritin levels were consistently decreased across the trimesters among the pregnant women. Albumin level showed significant decrease (p=0.01) across the trimesters while there was a statistically significant decrease in the ferritin level in the 2nd and 3rd trimesters,: (p=0,001, p=0.01) respectively, in comparison with the 1st trimester. Total protein significantly decreased in the 3rd trimester when compared to the 1st trimester (p=0.01). Folate level was decreased in the 2nd trimester when compared to the 3rd trimester (p=0.001). There was a significant increase in the serum iron level in the 3rd trimester when compared to the 2nd trimester (p=0.01). The UIBC showed a significant decrease in the 3rd trimester when compared to the 1st and 2nd trimesters (p=0.01). Percent transferrin saturation (TS%) in the 2nd trimester was decreased in comparison with the 1st and 3rd trimesters and the difference between the trimesters was statistically significant (p=0.01). Vitamin B12, sTfR and TIBC did not show any significant changes across the trimesters. Haemoglobin (Hb) concentration, packed cell volume (PCV), mean cell volume (MCV) did not show any significant changes across the trimesters but were decreased in comparison with the control values. Total and differential white blood cell count (WBC) did not show any significant changes across the trimesters. Platelets showed significant decrease in the 2nd (p=0.001) in comparison with the 1st trimester. Serum iron showed significant positive correlations with TIBC and TS% across the trimesters and negatively with UIBC only in the 2nd trimester. Ferritin correlated positively with albumin in the 2nd trimester and BMI in the 1st trimester. In conclusion, this is the first longitudinal study to be carried out on normal pregnant women in Cross River State, South-South Nigeria. The decrease in the levels of vitamin B12 and folate observed more in the 2nnd trimester needs to be explored.