A LONGITUDINAL STUDY OF CD4+ CELL COUNT AND LYMPHOCYTE (PERCENTAGE AND ABSOLUTE) COUNTS OF PREGNANT WOMEN ATTENDING ANTENATAL CLINICS AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, NIGERIA.

Abstract

Background: Pregnancy is associated with changes in the hormonal and immunological environment in order to support a healthy pregnancy. The maternal immune system during pregnancy is altered to actively tolerate the semi-allogeneic fetus. Aim: To determine the levels of CD4+ cell and lymphocyte (percentage and absolute) counts of pregnant women attending antenatal clinics at NnamdiAzikiwe University Teaching Hospital Nnewi,  Anambra State, Nigeria.Methods: One hundred and sixty (160) apparently healthy pregnant women who presented for booking in their first trimesters at the antenatal clinics of NAUTH, Nnewi constituted the study population. An equivalent number of age-matched non-pregnant women were used as the control groups. Five millilitres (5ml) of venous blood was collected from each subject by means of a hypodermic syringe and needle using a standard clean venipuncture technique. 2 mls was aliquoted into plain tubes for screening for HIV 1 & II, Hepatitis B surface Antigen (HBs Ag), Hepatitis C virus (HCV), while the remaining 3 mls was placed into potassium EDTA anticoagulated tubes for malaria parasite screening, CD4+ cell and lymphocyte (percentage and absolute) counts. The CD4+ cell counts were performed using parteccyflow counter, while the lymphocyte counts were done using automated haematology analyzer. The same procedures were conducted on non-pregnant controls and pregnancy test was also done to confirm they were not pregnant. The pregnant women were followed up till the last trimester.Results: The mean levels of CD4+ cell count in first (660.12± 484.92), second (625.45± 160.17), and third (621.92 ± 159.40) trimesters were significantly decreased compared to the control subjects (764.27 ± 182.58) (F=11.3, P<0.001).lymphocyte percentage showed a significant reduction in the first (33.83±35.05), second (31.15±32.48) and third (29.25±30.52), compared to controls (38.05±39.40) (F=136.4, P<0.001). Equally, absolute lymphocyte count was significantly decreased when the first (2.36±0.47), second (2.09±0.51) and third (1.85±0.52) were compared to the controls (3.10±0.76) (F=181.5, P<0.001).

When compared across the trimesters the mean CD4+ cell count showed no significant decrease from the first (660.12 ±484.92), to the third (621.92±159.40) trimester (F=1.0, P=0.386) while the percentage and absolute lymphocytes were significantly decreased from the first trimester. (33.83 ± 35.05) and (2.36±0.47), to the last trimester (29.25 ± 30.52) and (1.85 ± 0.52 (F=50.4, P< 0.001) and (F = 53.2, P<0.001).Conclusion: This study has shown that levels of CD4⁺ cell count and lymphocyte counts are decreased in pregnancy. Therefore, proper management of pregnancies at risk is needful to prevent unhealthy pregnancy outcome.