The Relationship between Haemoglobin Concentration and Pregnancy Outcomes in Women with Pre-Eclampsia in a Tertiary Hospital in South-Southern, Nigeria

Abstract

Background: Pre-eclampsia is a multi-systemic disorder defined as hypertension with significant proteinuria occurring in the second half of pregnancy in a woman who was previously non- hypertensive and non-proteinuric. Its incidence ranges between 2% to 8% of all pregnancies worldwide and between 2% to 16.7% in Nigeria. The measurement of the haemoglobin concentration in pre-eclamptics may be of great prognostic value for the mother and the foetus. This study investigated the haemoglobin concentration in pre-eclamptics and its relationship with feto-maternal outcomes. Methods: This cross-sectional longitudinal study included 63 pregnant women with pre-eclampsia who were between the gestational ages of 28 weeks and 41 weeks at the University of Port Harcourt Teaching Hospital (UPTH). This study population consisted of a cross- section of pregnant women with sustained elevated blood pressure and proteinuria. Haemoglobin concentrations were assayed in the UPTH Haematology laboratory. A structured questionnaire was used to obtain socio-demographic information. Results: The mean haemoglobin concentration for the study population was 11.70±1.7g/dl. The mean haemoglobin concentration for severe and mild pre-eclampsia was 11.95±1.74g/dl and 11.39±1.69g/dl, respectively (p=0.21). Mean haemoglobin concentration for subjects who had worsening proteinuria was 12.33±1.08g/dl, while that for those without worsening proteinuria was 11.38±1.62g/dl (p=0.04), suggesting that those subjects with worsening proteinuria had higher intrapartum haemoglobin concentration than those without. Bivariate analysis showed that haemoglobin concentration and postpartum haemorrhage were significantly associated (r= -0.278, p= 0.027), even after controlling for estimated blood loss (r= -0.407, p= 0.001), suggesting that postpartum haemorrhage is likely to occur with decreasing haemoglobin concentration