The mean age of pregnancy was found to be 26.04 ± 3.47 years and the median age was 26 years which was slightly above the national data of census of Nepal 2011. WHO’s [4] report of 44% prevalence of anemia in Nepal was consistent with the present study. The result of the present study was homogenous to WHO survey for mean hemoglobin concentration of average Nepali pregnant women estimated at 11.1 g/dL (10.8–11.5 g/dL with 95% credibility interval) [4]. Similar to studies in other parts of the country, [7,8,9,10] 45.61% of pregnant women were found to have hemoglobin concentrations less than 10 g/dL and 0.8% with hemoglobin concentration less than 7 g/dL. This finding was far from similar to the 2016 Nepal DHS Key indicators [11] which reported anemia in this part of Nepal to be around 28%. The prevalence of anemia throughout the country is however similar to the present study (46%). [10].
The present study showed significant positive correlation between maternal and fetal hemoglobin concentrations like Dapper DV et al. [12] in Nigeria, McElroy PD et al. [13] in Kenya, and Alizadeh L et al. [14] in Iran. No significant correlation was observed between maternal and fetal white cell count and MCHC [12,13,14]. A positive linear Pearson correlation was observed between mean hemoglobin and PCV of cord blood and maternal blood. All these results were similar to the ones observed by Nneli R et al. [15] Singla PN et al. [16] and Al-hilli NM et al. [17]. In contrast to the present study, some previous investigators including Qaiser DH et al., [18] Kilbride J et al., [19] and Mamoury GH et al. [20] have failed to find a relationship between the maternal and cord blood hemoglobin.
The present study showed 5.7% of the fetuses had low hemoglobin concentration, 23.94% had low MCV, 18.24% had low MCH and none of the fetuses had low MCHC which was a constant finding with Abdelgader EA et al. [21] and Steer PJ [22]. The cord blood hemoglobin (16.8 g/dL) of healthy term neonates in this study was uniform with those reported from studies in the west [23, 24].
Qaiser DH et al. [25] measured the mean of all CBC parameters aiming to maintain refrencing, and found the mean hemoglobin = 14.99 ± 1.47 g/dL, RBC = 4.29 ± 0.44, PCV = 45.65 ± 4.83, MCV = 105.81 ± 6.24, MCH = 34.96 ± 2.11, MCHC = 32.47 ± 2.12, TC = 13.61 ± 4.23 and platelet count = 256.25 ± 76.54 in the umbilical cord blood. The result showed similar findings with the present study but with a slightly higher total WBC count.
As the study was conducted in only one tertiary care center and that too with a limited number of patients, the result does not represent the pregnant women in Western Development Region of Nepal. Also, the study only included the patients attending hospital for delivery so the results cannot be generalized as it may not be a true reflection of the general population. However researchers have found the increasing trend of hospital based deliveries in urban population and Pokhara being an urban city, the data and results presented could actually represent the urban population of Pokhara valley. Socioeconomic status of the pregnant women was also not considered in the study. Moreover, further studies are to be conducted in the field to achieve complete results.
