Biochemical and Hematological Profile of Normal Pregnant Women in Gaza Governorate, Gaza strip

Abstract

Background: Pregnancy is associated with normal physiological changes that assist the nurturing and survival of the fetus. Biochemical and hematological parameters reflect these adaptive changes which become very important in the event of complications. The lives of eight million women are threatened, and more than 500,000 women are estimated to have died as a result of causes related to pregnancy and childbirth complications. Objective: To assess biochemical and hematological profile of normal pregnant women in Gaza Governorate,Gaza strip. Materials and Methods: This case-control design study included 150 healthy pregnant women sub-divided into three groups each consists of 50 women comprising at 1st, 2nd and 3rd trimesters, and 50 healthy non pregnant women. Questionnaire interviews were applied. Biochemical and hematological profiles were assesed. Data were computer analyzed using SPSS program version 18. Results: The mean ages of controls and pregnant women in the first, second and third trimesters were 27.4±6.3, 27.6±6.5, 27.3±6.8 and 27.7±6.6 years old, respectively. Unemployment women and lower family income were more prevalent among pregnant women (P=0.008 and P=0.000). Medical history of the study population showed that the frequency of the previous pregnancy in controls was significantly lower than that in cases(P=0.020). In general, blood pressure of the study population was within the normal range. However, diastolic blood pressures decreased in the first and second trimesters and then returned nearly to that of controls (P=0.017). In the 3rd food and drink intake showed that pregnant women ate less fish and egg (P=0.003 and P=0.005) and more fruits and vegetables(P=0.046)than non pregnant women. Coffee was drunk more frequently by non pregnant women (P=0.002). Glucose level was slightly lower in pregnant women than non pregnant women, with no significant difference (P=0.303).Cholesterol, triacylglycerol and low density lipoprotein (LDL-C) were significantly higher in pregnant women particularly in the 2nd and 3rd trimesters compared to non pregnant women (P=0.000). However, High density lipoprotein (HDL-C) showed no significant change in pregnant and non pregnant women (P=0.769). Total protein, albumin were significantly decreased particularly in the 2nd and 3rd trimesters compared to non pregnant women (P=0.000), whereas globulin showed no significant difference (P=0.088).Also, no significant change was observed in the activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzymes among pregnant and non pregnant women (P=0.211 and P=0.886, respectively). However, Alkaline Phosphatase (ALP) enzyme activity was significantly higher in pregnant women particularly in the 3rd trimester (P=0.000).Urea, creatinine and uric acid concentrations were significantly lower in pregnant women in the 1st, 2nd and 3rd trimesters compared to non pregnant women (P=0.000, 0.000 and 0.027, respectively). There was significant decrease in calcium concentration particularly in the 3rd trimester (P=0.015).White blood cells and neutrophils were progressively increased in pregnant women with significant differences among various groups (P=0.002 and P=0.000 ) whereas lymphocyte count, Red blood cell count, hemoglobin, hematocrit, Mean corpuscular hemoglobin concentration (MCHC) and platelet were significantly decreased in pregnant women compared to non pregnant women as pregnancy advanced (P<0.05). There was no significant change in Mean corpuscular volume (MCV), Mean corpuscular hemoglobin (MCH)(P>0.05). Conclusions: Biochemical and hematological parameters were altered during pregnancy. Cholesterol, Triacyglycerol, LDL-C and ALP were significantly increased whereas total Protein, albumin, urea, creatinine, uric acid and calcium were significantly decreased. WBC and neutrophils were significantly higher in pregnant women whereas RBC, hemoglobin, hematocrit, MCHC and platelet were lower.