Assessment of Some Haematological and Systemic Inflammatory Markers among Pregnant Women with Hypertension at the University of Port Harcourt Teaching Hospital, Nigeria

Abstract

Introduction: Hypertension in pregnancy is one of the most common and potentially life-threatening complications of pregnancy. Pregnancy is known to be associated with various physiological changes ranging from increased plasma volume and red blood cell mass, leucocytosis, and adaptive immunological modifications to the relative hypercoagulable state of pregnancy. This syndrome has been recognized for centuries but aetiology remains uncertain, limiting effective intervention. This study aimed to assess some haematological and systemic inflammatory markers among hypertensive pregnant women attending antenatal care in selected health centres in Port Harcourt, Rivers State.

Materials and Methods: A cross-sectional study was employed for the study, which comprised 150 pregnant women, 75 normotensive pregnant women as control, and 75 hypertensive pregnant women, all between the ages of 18 and 43 years. Socio-demographic data was obtained from pregnant women using a well-structured questionnaire. Three (3) ml of venous blood was collected aseptically from the participants and dispensed into ethylene diamine tetraacetic acid (EDTA) anticoagulant bottle for full blood count (FBC) assessment using a Three (3) part Haematology autoanalyzer. The data generated from this study was analyzed using GraphPad Prism software version 6.00, USA. Data was presented as means and standard deviation, and the two means were compared using student t-test analysis.

Results: Among the 75 hypertensive women studied, 27 (36%) were classified as having stage 1 hypertension and 48 (64%) as stage 2 hypertension. The systolic and diastolic blood pressure status of women in the hypertensive group was significantly higher than those of women in the normotensive control group (p<0.001). Mean values of haematologic parameters measured for women in the hypertensive group was as follows: Hb (10.74±2.13), PCV (32.64±6.15), RBC (5.25±9.71), MCV (79.85±11.02), MCH (26.81±7.87), MCHC (31.31±4.13), for WBC (8.29±16.81), Platelets (198.85±78.02), Neutrophils (57.85±14.52), Lymphocytes (35.28±14.52), Monocytes (3.76±1.87), and Eosinophils (2.15±1.99). Similar reading was noted for these parameters among the normotensive control, except for RBC, Neutrophils whose values decreased, and Eosinophils increased in hypertensive women. In the association of severity of hypertension with haematologic parameter assayed, it was observed that only monocyte level differed significantly between the 2 stages of hypertension. The mean monocyte level was significantly higher among stage 1 hypertensive patients than stage 2 hypertensive patients (4.04±2.25 and 3.60±1.59, respectively; t=0.949, p=0.038). MCH was shown to correlate significantly inversely with the severity of hypertension in the normotensive control group (R=-0.256, p=0.002).

Conclusion: During pregnancy, the occurrence of hypertension poses additional challenges to the haematopoietic system with resultant changes in haematological parameters, hence, simple, readily available clinical and laboratory parameters as indicators of the likely outcome of pregnancies complicated by hypertension are needed.