http://informahealthcare.com/jmf ISSN: 1476-7058 (print), 1476-4954 (electronic) J Matern Fetal Neonatal Med, Early Online: 1–5 ! 2014 Informa UK Ltd. DOI: 10.3109/14767058.2014.927424
ORIGINAL ARTICLE
Is there association between ABO blood group and the risk factors of unfavorable outcomes of pregnancy?
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
Nayer Seyfizadeh1, Narges Seyfizadeh1,2, Bahman Yousefi3, Sajad Borzoueisileh4, Maryam Majidinia3, Dariush Shanehbandi1, and Mohammad Ali Jahani5 1
Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, 2Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran, 3Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran, 4Department of Radiology, Yasuj University of Medical Sciences, Yasuj, Iran and 5Department of Health Service Management, Babol University of Medical Sciences, Babol, Iran Abstract
Keywords
There are four major blood groups in human based on the presence of A and B antigens. ABO gene encodes A and B antigens on the surface of red blood cells and there are reported relations between this blood phenotype and pregnancy outcomes in the women. In this study, medical records of 792 healthy pregnant women were investigated and their age and blood test results including blood group with fasting blood sugar, hemoglobin, hematocrit, urea, creatinine and red blood cell counts were analyzed in statistical package for the social sciences. The RBC count in AB blood type was significantly higher than A and O blood group, also FBS level in the people with AB blood group was meaningfully higher than A group. But the mean of HGB and HCT were not significantly different between groups. The serum urea in the AB group was higher than the three other groups and also it was significantly higher in B compared to O and A blood groups. The serum creatinine in the AB group was higher than the three other groups too. Also it was significantly higher in the B group compared to A blood groups. These results indicate that the ABO blood group may have association with some of the risk factors of the unfavorable outcomes of pregnancy and it may be one of the prognostic tools, also it addresses more extensive studies.
ABO blood group, anemia, gestational diabetes, hypertensive disorders, pregnancy
Introduction Human red blood cells consist of nearly 300 diverse antigenic expressions, The term ‘‘blood group’’ refers to the antigen phenotype that is the expression of the inborn genes, such as A, B and O in the ABO system. The antigenic determinants are formed in the Golgi apparatus by specific glycosyltransferase enzymes. The incidences of some diseases are associated to blood type. It was suggested that the ABO blood type formation had evolved in both humans and other primates. This is clear that ABO blood groups provide a special vulnerability to individuals possessing a special ABO blood group. There are four major blood groups in human based on the presence of A and B antigens on the surface of red blood cells (RBCs) [1]. ABO gene encodes these antigens with three main alleles (A, B and O) [1]. Recent studies have shown a different risk of some disease [2], such as cancer in individuals with different blood types [3–5]. There are relations between blood phenotype and pregnancy outcomes such as preeclampsia, the women with A and
Address of correspondence: Sajad Borzoueisileh, Department of Radiology, Yasuj University of Medical Sciences, Yasuj, Iran. E-mail: [email protected]
History Received 21 October 2013 Accepted 20 May 2014 Published online 17 July 2014
AB blood group are at higher risk compared with O type individuals [6]. Also because of the role of ABO blood groups on the hemostatic process and thrombus formation in order to prevent the syndrome and improve prognosis, special attention should be given to pregnant women carrying the AB blood group [7]. Medical history, physical examination and the quantification of the erythrocyte indices is the first step to assessment of an anemic pregnant person [8]. The complete blood count (CBC) is often used as a broad screening test to determine an individual’s general health status [9] and anemia, infection, inflammation, bleeding disorder or leukemia [10,11]. Red blood cell count is the number of the red blood cells (RBC) in blood and is an indicator of individuals’ health [11]. RBCs are uniform in size and shape normally but significant variations can occur with conditions such as vitamin B12 and iron deficiencies [12,13]. Hemoglobin (HGB) measures the amount of the oxygen-carrying protein in the blood [14]. Hematocrit (HCT) measures the percentage of the blood that consists of red blood cells [15]. Urea serves an important role in the metabolism of nitrogen-containing compounds [16]. The association of ABO blood group and the indices of anemia are not studied among pregnant women yet. In this study, the fasting blood sugar (FBS), HGB, HCT, urea, serum
2
N. Seyfizadeh et al.
creatinine (Scr) and RBC counts of pregnant women are compared based on their age and blood group.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
Materials and methods Medical records of 792 healthy pregnant women in Tabriz health centers were analyzed. Among this population, 206 individuals had A blood group and 199, 198 and 189 people had O, B and AB phenotype, respectively. The life style and weight was matched and the people with former risky pregnancy, also the individuals with the history of heart and renal disorder and diabetes in their close family were excluded from the study. The age and blood test results including blood group (BG), FBS, HGB, HCT, urea, Scr and RBC counts during the second trimester of their pregnancies were collected. The data were analyzed in statistical package for the social sciences (SPSS) by ANOVA, Tukey and regression tests.
Results The mean age was 25.24±5.97 years. The mean age of A, B, AB and O group were not significantly different, while they were 25.77±5.70, 24.36±6.16, 25.71±6.06 and 25.12±5.91 respectively. The comparison of RBC counts, hemoglobin, serum creatinine, hematocrit, FBS and serum urea in pregnant women with different blood group are shown in Figure 1. The RBC count in the AB group is significantly higher than A (p50.005) and O (p50.05) blood group, also FBS of the AB group was significantly higher than the A group (p50.05). But the mean of HGB and HCT were not significantly different between groups. The serum urea in the AB group was higher than the three other groups (p50.005). Also it was significantly higher in the B group compared to O (p50.05) and A (p50.05) blood groups.
J Matern Fetal Neonatal Med, Early Online: 1–5
The serum creatinine in the AB group was higher than the three other groups (p50.005) too. Also it was significantly higher in the B group compared to the A (p50.05) group. The comparison of RBC counts, hemoglobin, serum creatinine, hematocrit, FBS and serum urea in pregnant women with different ages are shown in Figure 2. The RBC count, HGB, HCT, serum urea and creatinine were not significantly different in different ages but the mean of FBS in 435 years old women was higher than 520 (p50.05) and 25–29.9 (p50.05) years old women. The regression between age of the pregnant women and their RBC counts, hemoglobin and FBS was shown in Figure 3. The other measured parameters have no significant regression with the age.
Discussions Anemia is one of the risk factors of an unfavorable outcome of pregnancy. The association of ABO blood group and the indices of anemia were not studied among pregnant women yet. At this study, the age, blood group, fasting blood sugar, hemoglobin, hematocrit, uric acid, serum creatinine and red blood cell counts of 792 pregnant women were investigated and these parameters were compared among ABO blood groups and also different ages. Although the RBC counts of all groups were at the lower limit of normal range, its count in the AB group was significantly higher than A and O groups. On the other hand, the HGB and HCT were not significantly different between blood groups but HGB was in lower limits of normal range and HCT was lower than normal. Also the counts of RBCs and HGB significantly decrease with mother age. Although the association between gestational anemia and ABO blood group was not studied yet, some indices of the anemia were studied in postpartum women and newborns by
Figure 1. The comparison of RBC counts, hemoglobin, creatinine, hematocrit, FBS and urea for each blood group in pregnant women.
ABO blood group
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
DOI: 10.3109/14767058.2014.927424
3
Figure 2. The comparison of RBC counts, hemoglobin, creatinine, hematocrit, FBS and urea with different age.
Wojtyla et al. [17] that they did not confirm any significant differences between HCT, HGB and RBC values between urban and rural mothers. They have reported that the HCT levels were at the lower limit of normal in both cases. Also Harm et al. [18] reported some changes in hematologic indices in Caucasian and non-Caucasian pregnant women in the United States. Vandevijvere et al. [19] have concluded that some groups of women need to be targeted as they are at higher risk of inadequate folate status. Akingbola et al. [20] reported that pregnancy in healthy women in Ibadan, south-western Nigeria is characterized by lowest values of hemoglobin parameters in trimester three and there are significant differences between the WBC, platelet counts, RBC, PCT and PDW of women between the three trimesters. In Mexico, 20.6% of pregnant women suffer from anemia, especially those between 15 and 16 years old, who prevail in 42.4 and 34.3%, respectively. Almost half the cases are due to iron deficiency. This type of anemia is associated with a higher risk of pre-term delivery, of low birth weight and prenatal death [8]. Fujimori et al. [21] have studied anemia in Brazilian pregnant women before and after flour fortification with iron and they have reported that frequency of anemia decrease after fortification. Many factors are known to effect on incidence Diabetes and high FBS level but little has known of the prognostic influence of various blood groups. In our investigation, FBS of the AB blood group was higher than the A group but the differences between the other blood groups were not statistically significant. Likewise, the FBS had significant regression with mother age. Although our study population was healthy, Corbould et al. [22] have introduced the fasting blood glucose predicts response to metformin as an alternative to insulin therapy in women with gestational diabetes mellitus. In another study. Ejezie and Onwusi [23]
has reported that FBS levels are higher in AB than the O, A and B blood groups. Our results indicated that the serum urea in the AB group was higher than the three other groups and it was higher in B compared to O and A blood group. The effect of blood urea concentrations on pregnancy were not studied in human population yet but Gath et al. [24] have studied the effects of elevated blood urea concentrations on establishment of pregnancy and embryo development in beef heifers, they did not find adverse effects of urea on reproduction and they have suggested that this adverse effect may occur prior to ovulation or fertilization following an increase in protein intake. Plasma creatinine concentration is a well-known clinical demonstration of renal function and predictor of hypertensive disorders during pregnancy [25]. Our results showed that the serum creatinine level in the AB blood group was higher than the three other groups and it was significantly higher in B compared to A blood group. Girling [25] has reported that plasma creatinine concentration decreases during pregnancy and upper limit normal range can be taken as 85 mmol/l, 80 mmol/l and 90 mmol/l in the first, second and third trimesters of pregnancy, respectively. Young et al. [26] have concluded that pregnancy was not associated with development and progression of diabetic nephropathy in women with or without mild renal dysfunction.
Conclusions The results of our study indicate that ABO blood group may have association with some of the risk factors of an unfavorable outcome of pregnancy, but based on this finding it would be reasonable to conduct extensive studies to determine the clinical significance of these differences.
N. Seyfizadeh et al.
Figure 3. The regression between age and RBC count, hemoglobin and FBS in pregnant women.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
4 J Matern Fetal Neonatal Med, Early Online: 1–5
DOI: 10.3109/14767058.2014.927424
Declaration of interest Authors report no conflicts of interest.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
References 1. Wolpin BM, Kraft P, Xu M, et al. Variant ABO blood group alleles, secretor status, and risk of pancreatic cancer: results from the Pancreatic Cancer Cohort Consortium. Cancer Epidemiol Biomarkers Prevent 2010;19:3140–9. 2. Nakao M, Matsuo K, Ito H, et al. ABO genotype and the risk of gastric cancer, atrophic gastritis, and Helicobacter pylori infection. Cancer Epidemiol Biomarkers Prevent 2011;20:1665–72. 3. Garriga R, Ghossein NA. The ABO blood groups and their relation to the radiation response in carcinoma of the cervix. Cancer 1963; 16:170–2. 4. Wolpin BM, Chan AT, Hartge P, et al. ABO blood group and the risk of pancreatic cancer. J Natl Cancer Inst 2009;101:424–31. 5. Dabelsteen E, Gao S. ABO blood-group antigens in oral cancer. J Dent Res 2005;84:21–8. 6. Phaloprakarn C, Tangjitgamol S. Maternal ABO blood group and adverse pregnancy outcomes. J Perinatol 2013;33:107–11. 7. Alpoim PN, de Barros Pinheiro M, Junqueira DR, Alpoim PN, et al. Preeclampsia and ABO blood groups: a systematic review and meta-analysis. Mol Biol Rep 2013;40:2253–61. 8. Montoya Romero Jde J, Castelazo Morales E, Valerio Castro E, et al. [Review by expert group in the diagnosis and treatment of anemia in pregnant women. Federacion Mexicana de Colegios de Obstetricia y Ginecologia]. Ginecol Obstet Mex 2012;80:563–80. 9. Conibear SA. Long term health effects of thorium compounds on exposed workers: the complete blood count. Health Phys 1983;44: 231–7. 10. Ufearo H, Kambal K, Onojobi GO, et al. Complete blood count, measures of iron status and inflammatory markers in inner-city African Americans with undiagnosed hepatitis C seropositivity. Clin Chim Acta 2010;411:653–6. 11. Walters MC, Abelson HT. Interpretation of the complete blood count. Pediatr Clin North Am 1996;43:599–622. 12. Dabrowska MM, Mikula T, Wiercinska-Drapalo A. The anemia prevalence and the association between complete blood count analysis and renal function parameters in HIV-1-infected patients. Curr HIV Res 2012;10:247–51.
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5
13. Dixon LR. The complete blood count: physiologic basis and clinical usage. J Perinat Neonatal Nurs 1997;11:1–18. 14. Yazdani M, Tadbiri M, Shakeri S. Maternal hemoglobin level, prematurity, and low birth weight. Int J Gynaecol Obstet 2004;85: 163–4. 15. Collins AJ, Ma JZ, Ebben J. Impact of hematocrit on morbidity and mortality. Semin Nephrol 2000;20:345–9. 16. Scheinfeld NS. Urea: a review of scientific and clinical data. Skinmed 2010;8:102–6. 17. Wojtyła C, Bilin´ski P, Paprzycki P, Warzocha K. Haematological parameters in postpartum women and their babies in Poland – comparison of urban and rural areas. Ann Agric Environ Med 2011; 18:380–5. 18. Harm SK, Yazer MH, Waters JH. Changes in hematologic indices in caucasian and non-caucasian pregnant women in the United States. Korean J Hematol 2012;47:136–41. 19. Vandevijvere S, Amsalkhir S, Van Oyen H, Moreno-Reyes R, . Determinants of folate status in pregnant women: results from a national cross-sectional survey in Belgium. Eur J Clin Nutr 2012; 66:1172–7. 20. Akingbola TS, Adewole IF, Adesina OA, et al. Haematological profile of healthy pregnant women in Ibadan, south-western Nigeria. J Obstet Gynaecol 2006;26:763–9. 21. Fujimori E, Sato AP, Szarfarc SC, et al. Anemia in Brazilian pregnant women before and after flour fortification with iron. Rev Saude Publica 2011;45:1027–35. 22. Corbould A, Swinton F, Radford A, et al. Fasting blood glucose predicts response to extended-release metformin in gestational diabetes mellitus. Aust N Z J Obstet Gynaecol 2013;53:125–9. 23. Ejezie FE, Onwusi EAO. Fasting blood glucose levels in different haemoglobin genotypes and blood groups. J College Med 2003;8: 53–5. 24. Gath VP, Crowe MA, O’Callaghan D, et al. Effects of diet type on establishment of pregnancy and embryo development in beef heifers. Anim Reprod Sci 2012;133:139–45. 25. Girling JC. Re-evaluation of plasma creatinine concentration in normal pregnancy. J Obstet Gynaecol 2000;20:128–31. 26. Young EC, Pires ML, Marques LP, et al. Effects of pregnancy on the onset and progression of diabetic nephropathy and of diabetic nephropathy on pregnancy outcomes. Diabetes Metab Syndr 2011; 5:137–42.
ORIGINAL ARTICLE
Is there association between ABO blood group and the risk factors of unfavorable outcomes of pregnancy?
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
Nayer Seyfizadeh1, Narges Seyfizadeh1,2, Bahman Yousefi3, Sajad Borzoueisileh4, Maryam Majidinia3, Dariush Shanehbandi1, and Mohammad Ali Jahani5 1
Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, 2Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran, 3Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran, 4Department of Radiology, Yasuj University of Medical Sciences, Yasuj, Iran and 5Department of Health Service Management, Babol University of Medical Sciences, Babol, Iran Abstract
Keywords
There are four major blood groups in human based on the presence of A and B antigens. ABO gene encodes A and B antigens on the surface of red blood cells and there are reported relations between this blood phenotype and pregnancy outcomes in the women. In this study, medical records of 792 healthy pregnant women were investigated and their age and blood test results including blood group with fasting blood sugar, hemoglobin, hematocrit, urea, creatinine and red blood cell counts were analyzed in statistical package for the social sciences. The RBC count in AB blood type was significantly higher than A and O blood group, also FBS level in the people with AB blood group was meaningfully higher than A group. But the mean of HGB and HCT were not significantly different between groups. The serum urea in the AB group was higher than the three other groups and also it was significantly higher in B compared to O and A blood groups. The serum creatinine in the AB group was higher than the three other groups too. Also it was significantly higher in the B group compared to A blood groups. These results indicate that the ABO blood group may have association with some of the risk factors of the unfavorable outcomes of pregnancy and it may be one of the prognostic tools, also it addresses more extensive studies.
ABO blood group, anemia, gestational diabetes, hypertensive disorders, pregnancy
Introduction Human red blood cells consist of nearly 300 diverse antigenic expressions, The term ‘‘blood group’’ refers to the antigen phenotype that is the expression of the inborn genes, such as A, B and O in the ABO system. The antigenic determinants are formed in the Golgi apparatus by specific glycosyltransferase enzymes. The incidences of some diseases are associated to blood type. It was suggested that the ABO blood type formation had evolved in both humans and other primates. This is clear that ABO blood groups provide a special vulnerability to individuals possessing a special ABO blood group. There are four major blood groups in human based on the presence of A and B antigens on the surface of red blood cells (RBCs) [1]. ABO gene encodes these antigens with three main alleles (A, B and O) [1]. Recent studies have shown a different risk of some disease [2], such as cancer in individuals with different blood types [3–5]. There are relations between blood phenotype and pregnancy outcomes such as preeclampsia, the women with A and
Address of correspondence: Sajad Borzoueisileh, Department of Radiology, Yasuj University of Medical Sciences, Yasuj, Iran. E-mail: [email protected]
History Received 21 October 2013 Accepted 20 May 2014 Published online 17 July 2014
AB blood group are at higher risk compared with O type individuals [6]. Also because of the role of ABO blood groups on the hemostatic process and thrombus formation in order to prevent the syndrome and improve prognosis, special attention should be given to pregnant women carrying the AB blood group [7]. Medical history, physical examination and the quantification of the erythrocyte indices is the first step to assessment of an anemic pregnant person [8]. The complete blood count (CBC) is often used as a broad screening test to determine an individual’s general health status [9] and anemia, infection, inflammation, bleeding disorder or leukemia [10,11]. Red blood cell count is the number of the red blood cells (RBC) in blood and is an indicator of individuals’ health [11]. RBCs are uniform in size and shape normally but significant variations can occur with conditions such as vitamin B12 and iron deficiencies [12,13]. Hemoglobin (HGB) measures the amount of the oxygen-carrying protein in the blood [14]. Hematocrit (HCT) measures the percentage of the blood that consists of red blood cells [15]. Urea serves an important role in the metabolism of nitrogen-containing compounds [16]. The association of ABO blood group and the indices of anemia are not studied among pregnant women yet. In this study, the fasting blood sugar (FBS), HGB, HCT, urea, serum
2
N. Seyfizadeh et al.
creatinine (Scr) and RBC counts of pregnant women are compared based on their age and blood group.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
Materials and methods Medical records of 792 healthy pregnant women in Tabriz health centers were analyzed. Among this population, 206 individuals had A blood group and 199, 198 and 189 people had O, B and AB phenotype, respectively. The life style and weight was matched and the people with former risky pregnancy, also the individuals with the history of heart and renal disorder and diabetes in their close family were excluded from the study. The age and blood test results including blood group (BG), FBS, HGB, HCT, urea, Scr and RBC counts during the second trimester of their pregnancies were collected. The data were analyzed in statistical package for the social sciences (SPSS) by ANOVA, Tukey and regression tests.
Results The mean age was 25.24±5.97 years. The mean age of A, B, AB and O group were not significantly different, while they were 25.77±5.70, 24.36±6.16, 25.71±6.06 and 25.12±5.91 respectively. The comparison of RBC counts, hemoglobin, serum creatinine, hematocrit, FBS and serum urea in pregnant women with different blood group are shown in Figure 1. The RBC count in the AB group is significantly higher than A (p50.005) and O (p50.05) blood group, also FBS of the AB group was significantly higher than the A group (p50.05). But the mean of HGB and HCT were not significantly different between groups. The serum urea in the AB group was higher than the three other groups (p50.005). Also it was significantly higher in the B group compared to O (p50.05) and A (p50.05) blood groups.
J Matern Fetal Neonatal Med, Early Online: 1–5
The serum creatinine in the AB group was higher than the three other groups (p50.005) too. Also it was significantly higher in the B group compared to the A (p50.05) group. The comparison of RBC counts, hemoglobin, serum creatinine, hematocrit, FBS and serum urea in pregnant women with different ages are shown in Figure 2. The RBC count, HGB, HCT, serum urea and creatinine were not significantly different in different ages but the mean of FBS in 435 years old women was higher than 520 (p50.05) and 25–29.9 (p50.05) years old women. The regression between age of the pregnant women and their RBC counts, hemoglobin and FBS was shown in Figure 3. The other measured parameters have no significant regression with the age.
Discussions Anemia is one of the risk factors of an unfavorable outcome of pregnancy. The association of ABO blood group and the indices of anemia were not studied among pregnant women yet. At this study, the age, blood group, fasting blood sugar, hemoglobin, hematocrit, uric acid, serum creatinine and red blood cell counts of 792 pregnant women were investigated and these parameters were compared among ABO blood groups and also different ages. Although the RBC counts of all groups were at the lower limit of normal range, its count in the AB group was significantly higher than A and O groups. On the other hand, the HGB and HCT were not significantly different between blood groups but HGB was in lower limits of normal range and HCT was lower than normal. Also the counts of RBCs and HGB significantly decrease with mother age. Although the association between gestational anemia and ABO blood group was not studied yet, some indices of the anemia were studied in postpartum women and newborns by
Figure 1. The comparison of RBC counts, hemoglobin, creatinine, hematocrit, FBS and urea for each blood group in pregnant women.
ABO blood group
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
DOI: 10.3109/14767058.2014.927424
3
Figure 2. The comparison of RBC counts, hemoglobin, creatinine, hematocrit, FBS and urea with different age.
Wojtyla et al. [17] that they did not confirm any significant differences between HCT, HGB and RBC values between urban and rural mothers. They have reported that the HCT levels were at the lower limit of normal in both cases. Also Harm et al. [18] reported some changes in hematologic indices in Caucasian and non-Caucasian pregnant women in the United States. Vandevijvere et al. [19] have concluded that some groups of women need to be targeted as they are at higher risk of inadequate folate status. Akingbola et al. [20] reported that pregnancy in healthy women in Ibadan, south-western Nigeria is characterized by lowest values of hemoglobin parameters in trimester three and there are significant differences between the WBC, platelet counts, RBC, PCT and PDW of women between the three trimesters. In Mexico, 20.6% of pregnant women suffer from anemia, especially those between 15 and 16 years old, who prevail in 42.4 and 34.3%, respectively. Almost half the cases are due to iron deficiency. This type of anemia is associated with a higher risk of pre-term delivery, of low birth weight and prenatal death [8]. Fujimori et al. [21] have studied anemia in Brazilian pregnant women before and after flour fortification with iron and they have reported that frequency of anemia decrease after fortification. Many factors are known to effect on incidence Diabetes and high FBS level but little has known of the prognostic influence of various blood groups. In our investigation, FBS of the AB blood group was higher than the A group but the differences between the other blood groups were not statistically significant. Likewise, the FBS had significant regression with mother age. Although our study population was healthy, Corbould et al. [22] have introduced the fasting blood glucose predicts response to metformin as an alternative to insulin therapy in women with gestational diabetes mellitus. In another study. Ejezie and Onwusi [23]
has reported that FBS levels are higher in AB than the O, A and B blood groups. Our results indicated that the serum urea in the AB group was higher than the three other groups and it was higher in B compared to O and A blood group. The effect of blood urea concentrations on pregnancy were not studied in human population yet but Gath et al. [24] have studied the effects of elevated blood urea concentrations on establishment of pregnancy and embryo development in beef heifers, they did not find adverse effects of urea on reproduction and they have suggested that this adverse effect may occur prior to ovulation or fertilization following an increase in protein intake. Plasma creatinine concentration is a well-known clinical demonstration of renal function and predictor of hypertensive disorders during pregnancy [25]. Our results showed that the serum creatinine level in the AB blood group was higher than the three other groups and it was significantly higher in B compared to A blood group. Girling [25] has reported that plasma creatinine concentration decreases during pregnancy and upper limit normal range can be taken as 85 mmol/l, 80 mmol/l and 90 mmol/l in the first, second and third trimesters of pregnancy, respectively. Young et al. [26] have concluded that pregnancy was not associated with development and progression of diabetic nephropathy in women with or without mild renal dysfunction.
Conclusions The results of our study indicate that ABO blood group may have association with some of the risk factors of an unfavorable outcome of pregnancy, but based on this finding it would be reasonable to conduct extensive studies to determine the clinical significance of these differences.
N. Seyfizadeh et al.
Figure 3. The regression between age and RBC count, hemoglobin and FBS in pregnant women.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
4 J Matern Fetal Neonatal Med, Early Online: 1–5
DOI: 10.3109/14767058.2014.927424
Declaration of interest Authors report no conflicts of interest.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by McMaster University on 01/21/15 For personal use only.
References 1. Wolpin BM, Kraft P, Xu M, et al. Variant ABO blood group alleles, secretor status, and risk of pancreatic cancer: results from the Pancreatic Cancer Cohort Consortium. Cancer Epidemiol Biomarkers Prevent 2010;19:3140–9. 2. Nakao M, Matsuo K, Ito H, et al. ABO genotype and the risk of gastric cancer, atrophic gastritis, and Helicobacter pylori infection. Cancer Epidemiol Biomarkers Prevent 2011;20:1665–72. 3. Garriga R, Ghossein NA. The ABO blood groups and their relation to the radiation response in carcinoma of the cervix. Cancer 1963; 16:170–2. 4. Wolpin BM, Chan AT, Hartge P, et al. ABO blood group and the risk of pancreatic cancer. J Natl Cancer Inst 2009;101:424–31. 5. Dabelsteen E, Gao S. ABO blood-group antigens in oral cancer. J Dent Res 2005;84:21–8. 6. Phaloprakarn C, Tangjitgamol S. Maternal ABO blood group and adverse pregnancy outcomes. J Perinatol 2013;33:107–11. 7. Alpoim PN, de Barros Pinheiro M, Junqueira DR, Alpoim PN, et al. Preeclampsia and ABO blood groups: a systematic review and meta-analysis. Mol Biol Rep 2013;40:2253–61. 8. Montoya Romero Jde J, Castelazo Morales E, Valerio Castro E, et al. [Review by expert group in the diagnosis and treatment of anemia in pregnant women. Federacion Mexicana de Colegios de Obstetricia y Ginecologia]. Ginecol Obstet Mex 2012;80:563–80. 9. Conibear SA. Long term health effects of thorium compounds on exposed workers: the complete blood count. Health Phys 1983;44: 231–7. 10. Ufearo H, Kambal K, Onojobi GO, et al. Complete blood count, measures of iron status and inflammatory markers in inner-city African Americans with undiagnosed hepatitis C seropositivity. Clin Chim Acta 2010;411:653–6. 11. Walters MC, Abelson HT. Interpretation of the complete blood count. Pediatr Clin North Am 1996;43:599–622. 12. Dabrowska MM, Mikula T, Wiercinska-Drapalo A. The anemia prevalence and the association between complete blood count analysis and renal function parameters in HIV-1-infected patients. Curr HIV Res 2012;10:247–51.
ABO blood group
5
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