Abstract
IntroductionNumerous biological parameters are physiologically modified during normal pregnancy, in particular hematology. The knowledge of these modifications of the maternal body by biologists and clinicians allows the screening of possible anomalies. In Morocco, the reference values of the complete blood count test for pregnant woman are missing, as are those specific to different trimesters of pregnancy. The aim of this study is to look for the reference values for healthy pregnant women of the Northwest region of Morocco, to compare them to those of non-pregnant women (control) and to those of the literature.MethodsBlood samples were taken voluntarily from 3898 healthy pregnant women from 18 to 46 years old who presented themselves at the center of health Kalaa and at the service of gynecology obstetrics of the Provincial Hospital Center of M'diq (Morocco), for prenatal care. To establish the reference intervals of the CBC for non-pregnant women, a control group was constituted by 7035 healthy women from 18 to 50 years old selected according to the Moroccan law of blood donation. The CBC was measured on a Sysmex KX21N® analyzer. For each sample a systematic blood smear was done to determine the leukocyte differential.ResultsA statistically significant difference between the pregnant women and control group was noted (p < 0.05) for all the hematological parameters: red blood cells, hematocrit, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, leukocytes, neutrophils, basophils, eosinophils, lymphocytes, monocytes, platelets and mean platelet volume. So, the comparison of the averages established between the first, second and third trimester of pregnancy showed the existence of a significant variation with regard to all the parameters of the CBC test looked for (p < 0.001).ConclusionThe present study provides additional baseline data for basic hematological parameters in healthy pregnant Moroccan women and concluded that pregnancy in women has the tendency to alter some hematological indices. For these reasons, there is an interest to take these modifications into account for optimal maternal and fetal medical care.
Highlights
Numerous biological parameters are physiologically modified during normal pregnancy, in particular hematology
With the aim of answering this deficit, we suggested the conduction of a preanalytical and analytical study to estimate the reference values of the complete blood count (CBC) test and the physiological modifications of the hematological parameters observed during pregnancy from a population of healthy pregnant Moroccan women from the Northwest region of Morocco
With the aim of constituting a control group, the reference intervals of the CBC were established for 7035 voluntary nonpregnant women, from 18 to 50 years old, premenopausal; always belonging to the northwest region of Morocco
Summary
Numerous biological parameters are physiologically modified during normal pregnancy, in particular hematology. The values of the complete blood count (CBC) parameters can vary according to numerous pre-analytical, analytical, pathological and physiological factors such as age, sex, height, environment, race, nutritional state, ethnic origin, lifestyle, biorhythms, consumption of tobacco, alcohol or medicine or still the pregnancy [1]. This last factor is associated with profound anatomical, physiological, biochemical and endocrine changes that affect multiple organs and systems. For the WHO, the threshold of anemia in pregnancy is a state in which the total circulating HGB concentration is less than 11g/dl; or HCT less than 33% at any time of the pregnancy [5]
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