Project – Haematological Profile of Pregnant Women Attending Antenatal Clinics in Selected General Hospitals in Lagos State, Nigeria

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Pregnancy is a critical physiological state characterized by significant changes in a woman’s body, including alterations in haematological parameters. These changes are essential for supporting fetal development, adapting to increased metabolic demands, and preparing the mother for delivery. Haematological parameters such as haemoglobin concentration, packed cell volume (PCV), red blood cell (RBC) count, white blood cell (WBC) count, and platelet levels are commonly affected during pregnancy due to hemodilution, increased plasma volume, hormonal changes, and nutritional demands (World Health Organization, 2021).

Anaemia remains one of the most common haematological disorders among pregnant women globally, particularly in developing countries. The World Health Organization (WHO) estimates that approximately 40% of pregnant women worldwide are anaemic, with the highest burden in sub-Saharan Africa, including Nigeria (WHO, 2021). Anaemia in pregnancy is associated with adverse maternal and fetal outcomes such as preterm delivery, low birth weight, postpartum haemorrhage, increased maternal mortality, and impaired cognitive development in infants (Balarajan et al., 2011).

In Nigeria, the prevalence of anaemia among pregnant women is particularly alarming due to factors such as poor nutritional intake, malaria infection, helminthic infestations, high parity, short birth intervals, and limited access to quality antenatal care services. Studies have shown that many pregnant women in urban and semi-urban areas still present with low haemoglobin levels despite attending antenatal clinics, indicating that antenatal attendance alone may not guarantee adequate haematological health (Agan et al., 2010).

Beyond anaemia, other haematological abnormalities such as thrombocytopenia and leukocytosis may also occur during pregnancy. Thrombocytopenia can increase the risk of bleeding complications during labour, while abnormal white blood cell counts may indicate infections or inflammatory conditions that can complicate pregnancy outcomes (Hoffbrand & Moss, 2016).

Lagos State, being one of the most densely populated and urbanized states in Nigeria, has a diverse population of pregnant women attending general hospitals for antenatal care. Despite the availability of healthcare services, variations in socio-economic status, nutrition, lifestyle, and disease burden may influence haematological profiles among pregnant women in the state. Therefore, assessing the haematological profile of pregnant women attending antenatal clinics in selected general hospitals in Lagos State is essential for early detection, prevention, and management of blood-related abnormalities.

Understanding these haematological patterns will provide valuable insight for clinicians, policymakers, and public health professionals in improving maternal health interventions and reducing pregnancy-related complications.

1.2 Statement of the Problem

Despite increased awareness and expansion of antenatal care services in Lagos State, pregnancy-related complications associated with abnormal haematological parameters continue to pose significant public health challenges. Anaemia, in particular, remains highly prevalent among pregnant women, even among those who regularly attend antenatal clinics. This raises concerns about the effectiveness of routine antenatal screening and the adequacy of preventive interventions such as iron supplementation and nutritional counselling.

In many general hospitals across Lagos State, pregnant women still present with varying degrees of anaemia, thrombocytopenia, and other haematological abnormalities that often go undetected until complications arise during labour or delivery. These conditions contribute significantly to maternal morbidity and mortality, as well as adverse neonatal outcomes such as low birth weight, prematurity, and perinatal death.

Furthermore, there is limited localized data on the comprehensive haematological profile of pregnant women in selected general hospitals within Lagos State. Most available studies focus primarily on anaemia without considering a broader spectrum of haematological indices such as white blood cell and platelet variations. This creates a gap in knowledge that limits effective clinical decision-making and targeted interventions.

The persistence of these challenges suggests that there may be underlying factors such as inadequate nutritional intake, late booking for antenatal care, undiagnosed infections, or poor adherence to prescribed supplements. Therefore, there is a need for an updated and detailed assessment of haematological parameters among pregnant women attending antenatal clinics in selected general hospitals in Lagos State to provide evidence-based data for improved maternal healthcare delivery.

1.3 Objectives of the Study

The main objective of this study is to assess the haematological profile of pregnant women attending antenatal clinics in selected general hospitals in Lagos State, Nigeria.

Specific objectives include:

1. To determine the haemoglobin level and prevalence of anaemia among pregnant women attending antenatal clinics.
2. To assess the red blood cell and packed cell volume levels of the respondents.
3. To evaluate the white blood cell and platelet counts among pregnant women.
4. To determine the overall pattern of haematological parameters across different trimesters of pregnancy.

1.4 Research Questions

1. What is the haemoglobin level and prevalence of anaemia among pregnant women attending antenatal clinics?
2. What are the red blood cell and packed cell volume levels among the respondents?
3. What are the white blood cell and platelet counts among pregnant women?
4. How do haematological parameters vary across different trimesters of pregnancy?

1.5 Research Hypothesis

H₀: There is no significant relationship between gestational age (trimester) and the haematological profile of pregnant women attending antenatal clinics in selected general hospitals in Lagos State.

H₁: There is a significant relationship between gestational age (trimester) and the haematological profile of pregnant women attending antenatal clinics in selected general hospitals in Lagos State.

1.6 Significance of the Study

This study will be beneficial to several stakeholders in the healthcare system. To clinicians and medical laboratory scientists, it will provide updated data on haematological variations among pregnant women, aiding accurate diagnosis and treatment. To pregnant women, the findings will increase awareness of the importance of antenatal screening and adherence to medical advice.

For policymakers and public health planners, the study will provide evidence-based information necessary for designing improved maternal health interventions and nutritional programs. It will also contribute to academic literature by providing baseline data for future research in haematology and maternal health in Lagos State and Nigeria at large.

1.7 Scope of the Study

This study is limited to pregnant women attending antenatal clinics in selected general hospitals in Lagos State, Nigeria. It focuses on key haematological parameters including haemoglobin concentration, packed cell volume, red blood cell count, white blood cell count, and platelet count. The study also considers variations across different trimesters of pregnancy.

1.8 Operational Definition of Terms

• Haematological Profile: The measurement and analysis of blood components such as RBC, WBC, platelets, haemoglobin, and PCV.
• Pregnant Women: Women who are currently carrying a developing fetus within the womb.
• Anaemia: A condition characterized by low haemoglobin concentration below normal levels.
• Antenatal Clinic: A healthcare service where pregnant women receive routine medical check-ups during pregnancy.
• Packed Cell Volume (PCV): The percentage of red blood cells in blood volume.

Project – Haematological Profile of Pregnant Women Attending Antenatal Clinics in Selected General Hospitals in Lagos State, Nigeria