Anaemia among women of child-bearing age: Contributions of alpha and beta-thalassaemia

Abstract

INTRODUCTION AND OBJECTIVES: Anaemia during pregnancy is attributed to iron deficiency and pregnant women prescribed iron supplements without investigating for a cause. However, aetiology can be diverse and iron efficiency may contribute only partly. We aimed to describe the aetiology of anaemia among women of child bearing age. METHODS: This descriptive study was conducted at Teaching Hospital, Ragama from June-December 2017. Patient database of deliveries between January 2015 and September 2016 at University Obstetrics Unit was screened (n=3636) to identify women with anaemia (haemoglobin<l l.5g/dl) at first antenatal visit (n=1396). Anaemic females were randomly recalled until a sample size of 250 is reached. Data were collected using an interviewer administered questionnaire and 8ml of venous blood was collected for full blood count, serum ferritin, capillary electrophoresis and alpha-globin genotype. Ethical approval was obtained from Ethics Committee of University of Kelaniya.RESULTS:Two hundred and fifty three females were recalled; 8 were excluded (currently pregnant). One hundred and seventeen (48%) females were anaemic (haemoglobin<l2.0g/dl) and further 22 had microcytosis (mean corpuscular volume <80fL) without anaemia. Of anaemic women, 28 (23.9%) had iron deficiency (ferritin<15nglml), 40 (34.2%) had low-normal serum ferritin (15-30ng/ml), 15 (12.8%) had beta-thalassaemia trait 2 (1. 7%) had haemoglobin E trait, 20 (17.0%) had alpha-thalassaemia trait and 1 (0.8%) had possible delta- ta-thalassaemia trait. Of non-anaemic women with microcytosis, 1 (4.5%) had beta-thalassaemia trait and 13 (59.0%) had alpha-thalassaemia trait. Four females co-inherited alpha- and beta-thalassaemia trait.CONCLUSION: Among anaemic females, 30% had thalassaemia of which majority had alpha-thalassaemia. 59% of females with non-anaemic microcytosis had alpha-thalassaemia. Both alpha- and beta-thalassaemia co-existed 4 women.