Erythrocyte Indices in Asymptomatic Malaria Infected Pregnant Women

Background: Red blood cell changes are one of the most common complications in malaria and they play a very crucial role in malaria pathogenesis. Malaria infections are one of the common causes of maternal anaemia especially during pregnancy. The aim of this study was to determine red cell indices of pregnant women with asymptomatic malaria.

Place and Duration of Study: Department of Haematology and Antenatal Unit both of Enugu State University of Science and Technology Teaching Hospital, between June and September 2022.

Methodology: The study population consisted of 90 pregnant women (65 pregnant women positive to malaria parasite without symptoms and 25 pregnant women negative to malaria parasite) and 26 control non-pregnant women. For the whole study population, red cell indices which include hemoglobin (HGB), packed cell volume (PCV), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width standard deviation (RDW-SD), red cell distribution width coefficient of variation (RDW-CV) were measured by automated haematology analyzer.

Results: In the asymptomatic malaria group (AMG), 21 (32.3%) had mild anaemia (HGB level 9.0-10.0 g/dl), 11 (16.9%) had moderate anaemia (HGB level 7.0-8.0 g/dl) and 2 (3.1%) had severe anaemia (HGB level <7.0 g/dl). Also in AMG group, the RDW-SD was 54.22 +/- 11.45 fl, whereas in control group it was 48.75 +/- 10.24 fl (p=0.002). Again in the AMG group the MCHC of those that had two pluses was 318.03 +/- 16.31 g/l, whereas in those that had one plus, it was 309 +/- 20.17 g/l. The comparison between the first, second and third trimester showed significant decrease in HGB (7.63 +/- 1.36 vs 11.64 +/- 0.72 g/dl) and PCV (26.98 +/- 5.14 vs 36.20 +/- 2.19 %) in third trimester compared to first trimester (p= <0.001, <0.001). whereas RDW-CV (18.96 +/- 5.04 vs 15.00 +/- 2.64 %) and RDW-SD (59.04 +/- 15.19 vs 49.16+/- 7.00 fl) (p= 0.002, 0.003) significantly increased in third trimester compared to first trimester

Conclusion: This study found anaemia in asymptomatic malaria infected pregnant women, significant decrease in haemoglobin and packed cell volume at third trimester, higher MCHC in those with two pluses of malaria and significant increase in red cell distribution width at third trimester.