Reticulocyte assessment as an indirect evaluation and elaboration of erythroid marrow output in the groups of pregnant women in Maiduguri, Nigeria

ABSTRACT

Nutritional anaemia is one of Nigeria's major public health problem among pregnant women. In this locality, no large scale study has been done to assess bone marrow activity in groups of pregnant women using Reticulocyte assessment. This result will serve as indirect evaluation and elaboration of erythroid marrow output in the pregnant women. To assess bone marrow activity in groups of pregnant women using Reticulocyte assessment as an indirect evaluation. 150 women covering the three trimesters of pregnancy were recruited into the study, prospectively. 101 multiparous and 49 primiparous pregnant women, consisting of 33 in the first trimester, 74 in the second trimester and 43 in the third trimester were investigated. Red blood cell count, Reticulocyte count and assessment were conducted by standard methods. The patients in the third trimester had statistically significant [P<0.05] lower reticulocyte values than those in the first and second trimesters. The primiparous pregnant women had statistically significant [P<0.05] higher reticulocyte values than the multiparous pregnant women. Absolute reticulocyte count results were 50.0 +/- 15.2, 60.0 +/- 18.4, 34.0 +/- 12.8 and 48.0 +/- 12.0 for first, second and third trimesters and combined group, respectively. Reticulocyte index was 1.5 +/- 0.6, 1.9 +/- 0.8, 0.8 +/- 0.6 for first, second and third trimesters, respectively and 1.5 +/- 0.5 for combined group. Reticulocyte production index was 0.9 +/- 0.2, 1.1 +/- 0.4, 0.7 +/- 0.5 and 0.7 +/- 0.4 for first, second and third trimesters and combined group, respectively. In this study, bone marrow activity as assessed by reticulocyte studies is on the lower side of the normal range, more so in the third trimester of pregnancy. Severe anaemia during pregnancy therefore remains endemic despite intervention measures such as the distribution of iron and folate tablets. One of the problems yet uninvestigated is the bone marrow turnover as affected by some other nutritional differences as well as malaria, heavy loads of helminths, and other inflammatory or infectious diseases. A successful strategy to combat anaemia, therefore, should address all the casual factors after their elucidation