Aetiology of Anaemia among Pregnant Women in Northern Ghana

This chapter evaluated the aetiology of anaemia in pregnant women in Northern Ghana. Maternal anaemia has significant adverse effects on both mothers and infants. The risk of death among pregnant women with severe anaemia has been reported to be twice that of mothers without severe anaemia. This hospital-based cross-sectional case-control study was conducted in the Obstetrics and Gynecology Department of the Regional Hospital Bolgatanga (RHB), Ghana, West Africa, from May 2013 to May 2014. A total of 400 pregnant women, comprising 253 anaemic and 147 non-anaemic pregnant women attending the antenatal clinic at the Bolgatanga Regional Hospital, Ghana, were selected for the study. Venous blood was collected and haemoglobin genotype, complete blood count and biochemical parameters [ferritin, iron, total iron binding capacity (TIBC), transferrin saturation (TfS), C-reactive protein (CRP) and bilirubin] were determined. Per the manufacturer's instructions, daily quality control checks were run on control specimens within specified limits. Thick blood films were prepared for malaria parasitemia, while early morning stool and midstream urine samples were examined for enteric and urogenital parasites, respectively. Anaemic pregnant women had a significantly lower mean HGB, HCT, MCV, and MCHC than their non-anaemic counterparts (p<0.0001). Conversely, there was a significantly higher mean WBC and RDW amongst anaemic pregnant women than non-naemic women (p<0.05). There were significantly reduced levels of HGB (p<0.0001), HCT (p<0.0001), MCV (p<0.0001), iron (0.0273), ferritin (p=0.018) and transferrin saturation (0.0391) and an increased WBC (p=0.006), RDW (p=0.0480), TIBC (p=0.0438) and positivity of CRP in the anaemic group compared to non-anaemic pregnant women. Plasmodium falciparum, Schistosoma hematobium, increased hemoglobinopathies (AS, SS, and SC), and intestinal parasite infections were associated with anaemic women. Iron deficiency is linked to a notable disruption in haematological and iron indices in pregnant women who are anaemic. Hemoglobinopathies and parasite infections further complicate this outcome.