Hemoglobinopatias e anemias em gestantes no Hospital Universitário de Campo Grande - MS

Abstract

The hemoglobinopathies are a group of inherited diseases that are highly variable in clinic diagnosis, from forms that are incompatible with life to asymptomatic heterozygotes carriers, who under stress like pregnancy, may have the disease. The detection of heterozygote carriers is of great importance for public health as they constitute potential sources of new heterozygotes and possible homozygotes. Nowadays the control of the hemoglobinopathies has been possible through genetic counseling and early diagnosis. Objective: to detect the frequency of hemoglobinopathies and anemia, make the socialdemographic profile in pregnant women at the Gynecology and Obstetrics clinic of the University Hospital Maria Aparecida Pedrossian, from the Federal University of Mato Grosso do Sul, from January to August, 2007. Materials and methods: transversal observing descriptive study. Indian pregnant women were excluded, so were mentally sick women and convicted ones. The dependant variables were the pregnant women; quantitative independent: age, income, schooling, length of pregnancy; qualitative independent: hemoglobinopathies carriers or not, ethnic group, having anemia or not. The project was approved in protocol no. 873 from December 11, 2006 according to Portaria 196/96 CNS. In statistical analysis, the programs Excel, Epi Info version 3.4.1 and Bio Estat 4.0 were used and the descriptive statistics was also carried out. For possible interactions among the variables the Q-square Test was used, corrected by Yates. Blood samples were taken and stored in vials with EDTA for selective tests (eritrogram; erythrocyte morphological analysis; osmotic resistance to NaCl 0.36%; qualitative electrophoresis of Hb in cellulose acetate, alkaline pH; cytological research of HbH intra-erythrocyte) and specific tests for defective hemoglobin (quantitative electrophoresis of Hb in cellulose acetate, alkaline pH; electrophoresis of Hb in agar gel, acid pH; falciform erythrocyte test ). A questionnaire was given to the pregnant women and positive cases received orientation concerning the detected abnormal hemoglobin. Results: from the 233 pregnant women who were analyzed, 12% presented hemoglobinopathies with the following frequencies: HbAS 3%; HbAC 0.8% and 0.4% of intermediate β-thalassemia. In 7.8% of the cases a conclusive diagnosis was not possible to be achieved as complementary exams were needed, but they suggest that the HbH is related to α-thalassemia. In anemia evaluation, 18% of the pregnant women presented some sort of anemia. The average age of the participants was 26 years, 19.3% were between 14 and 19; 48.5% were white and 51.5% were not white; 64.4% had finished or almost finished the eighth grade; the family income was more than five minimum salaries for 84.5%. As for the ancestry, 22.3% of the pregnant women were South American, 22.3% were European, 7.7% were African; 43.8% were born in Campo Grande and 27.4% were born in other brazilian states. Conclusion: the frequency of hemoglobinopathies and anemia found in the studied pregnant women, and the social-demographic profile delineated, shows the importance of correct and early diagnosis that point out indicators that can lead to preventive and helpful actions, in order to reduce mothers’ and children’s death in public health.