Hemoglobin Disorders and Scenario of Reproductive Medicine in Central India: Need for Family Planning, Antenatal-Pediatric Health Care and Amelioration Volume 2 - Issue 2

RS Balgir*

• Department of Biochemistry, ICMR - National Institute for Research in Tribal Health, Madhya Pradesh, India

Received:June 25, 2020   Published: July 07, 2020

Corresponding author:RS Balgir, Ex-Scientist F/Deputy Director (Senior Grade) & Head, Department of Biochemistry, ICMRNational Institute for Research in Tribal Health, Jabalpur, Madhya Pradesh, India

DOI: 10.32474/JCCM.2020.02.000134

 

Fulltext PDF

To view the Full Article   Peer-reviewed Article PDF

Abstract

Background: Hemoglobin disorders are autosomal recessively inherited, genetically transmitted monogenic blood defects, world-wide highly prevalent in tropical regions, and causing the major public health challenges in central India. In view of credit for the 2nd highest infant mortality rate (IMR) in Madhya Pradesh (70 per thousand live-births in the year 2010), it seems, therefore, carrier couples of the hemoglobinopathies might be one of the contributing factors for the high IMR in central India.

Objectives: The aim of this study is to investigate actual reproductive (antenatal and postnatal) scenario pertaining to fertility and mortality in couples afflicted with hemoglobin disorders. Methods: Couples (parents) including their offsprings with at least one affected/suspected case of hemoglobinopathies, referred to ICMR - National Institute for Research in Tribal Health, Jabalpur from the local NSCB Medical College and Hospital, were consecutively studied as matched case controls. A total of 171 couples was referred during the period from March through December 2010.

Results and Discussion: Out 171 couples, 80 were found normal and 91 couples had different hemoglobin disorders. It was observed that the number of conceptions (2.187 vs 1.800), livebirths (1.934 vs 1.562), surviving offsprings (1.802 vs 1.437), stillbirths (0.121 vs 0.062), neonatal deaths (0.132 vs 0.100), deaths under one year (0.153 vs 0.112), and deaths under 10 year (0.220 vs 0.125) per couple at the time of investigations was higher in couples with hemoglobinopathies than the normal controls. The number of stillbirths (0.121 vs 0.062) per couple was almost two times higher in couples with different hemoglobin disorders than in the controls. Carrier and affected families were imparted genetic/marriage counseling.

Conclusions: This study indicated that afflicted couples with these hereditary (genetic) disorders are increasing the affected offsprings. The increased production of abnormal offspring leads to increased morbidity and mortality and may be contributing towards increased neonatal/infant (antenatal and postnatal) mortality or reproductive wastage in the state of Madhya Pradesh. These couples are in urgent need of family planning, antenatal/postnatal health care and family welfare.

Keywords: β-thalassemia syndrome; Sickle cell anemia; Defective genetic endowments; Reproductive medicine; Family Planning; Antenatal health care; Genetic counseling

Abstract| Introduction| Materials and Methods| Results| Discussion| Acknowledgements| References|