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Ali, Eltigani Hassan (2022) Haematological and nutritional status of Sudanese women with sickle cell trait and anaemia: does sickle cell trait compromise birth outcomes? Doctoral thesis, London Metropolitan University.
This research programme has investigated the haematological and nutritional status of Sudanese women who have both sickle cell trait and sickle cell anaemia and has considered whether women with sickle cell trait experience worse outcomes of childbirth than those without.
Non pregnant group with sickle cell anaemia:
In this study, (n=39) sickle cell anaemia and healthy control (n=36) non-pregnant childbearing age women were recruited, anthropometric data and blood samples were collected for haematological study. The aim was to study the effect of sickle cell anaemia on the general health and nutritional status of Sudanese women.
Sickle cell anaemia affects the nutritional status of women of childbearing age. The women who were involved in this study were noted to be shorter than the healthy women, and they had low body mass indices and lower weight than the average for their unaffected peers.
Consanguineous marriage is more prevalent among people with sickle cell anaemia than among the wider population. Sickle cell anaemia affects the lifestyles of women of childbearing age and on average they attain lower educational qualifications than those who do not have the disease. In our previous study 2016, we found that sickle cell prevalence was high at 24.9% in the west of Sudan.
Pregnant sickle cell trait group:
Then as there was no registry for sickle cell trait in pregnant women we have to do some screening in the antenatal clinic to select our study group.
At their first antenatal visit, 367 pregnant women were screened for sickle cell trait through the use of haemoglobin electrophoresis. Of these, 34 were diagnosed with the condition. Pregnant women with sickle cell trait (HbAS) were found to exhibit abnormal haematological measurements late in pregnancy, and these measurements were lower than those in a group of healthy pregnant Sudanese women who comprised a control group. Women with sickle cell trait carried increased risks of miscarriage and stillbirth, and their babies weighed less at birth than those born to healthy women with normal haemoglobin (HbAA).
Fatty acids levels in sickle cell trait pregnant women:
Unexpectedly, pregnant women with sickle cell trait were found to have higher levels of fatty acids, in both the plasma and red blood cells (RBCs), than the control group, both early and late in pregnancy. The women with HbAS compared with the women without, had higher levels of saturated and monounsaturated fatty acids both early in pregnancy and late, until the time of delivery. However, in this study, it was found that healthy Sudanese pregnant women, with no sickle cell trait, had lower levels of fatty acids than pregnant women in other countries.
Conclusion:
This pilot study indicates that sickle cell anaemia affects the general health of Sudanese women, Pregnant Sudanese women with sickle cell trait face many challenges during pregnancy and childbirth, and they require more support than they receive currently. Health education and screening programmes should be implemented. Children born to women with sickle cell trait must be evaluated at birth and closely followed up to discover whether they carry the sickle cell gene and to evaluate their fatty acid levels to improve their nutritional status. Provision of fatty acid supplements for pregnant women with sickle cell trait during pregnancy and lactation should be considered. There is a need for further studies to increase understanding of the biological situation among pregnant women who have sickle cell disease and to improve their childbirth outcomes.
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