PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 29 Table 1. Reasons for Refusal to Participate in the Study Total Number of Refusals = 112 (15.4%) Financial problem, n (%) 32 (28.57) Will seek permission from husband/family members, n (%) 31 (27.68) Unwanted pregnancy and wanted to terminate the pregnancy, n (%) 25 (22.32) Found it unnecessary, n (%) 9 (8.04) Will consult a private consultant and get the test done, n (%) 9 (8.04) Have normal children in previous pregnancy, ßand hence, do not want to do the test, n (%) 3 (2.68) Their private consultant found it unnecessary, n (%) 2 (1.79) Religious and believe that God will protect them from all diseases, n (%) 1 (0.89) Of the 615 (84.6%) women, 30 (4.8%) women were found to have hemoglobinopathy traits (Table 2). Most common was the β-thalassemia trait (BTT; 3.2%). Among the 30 women with hemoglobinopathy trait, 26 (86.7%) were Hindus and 4 (13.3%) were Muslims. Among the Hindus, the predominant caste was Marathas (9 [34.61%]) followed by Lingayats (3 [11.54%]), and Lohars (3 [11.54%]). The consanguinity rate was significantly high (45%) in women with BTT trait than those without any hemoglobinopathy (22.92%) (P = .065). Also, 6 (30%) of the 20 women with BTT trait had a previous child with BTT. Table 3 shows the mean values of hematologic parameters in BTT and non-BTT cases. There were significant Table 4. The Diagnostic Accuracy of Hematologic Parameters in the BTT and Non-BTT Groups Hematologic Parameter BTT (n = 20) Non-BTT (n = 585) Sensitivity, % Specificity, % PPV, % NPV, % Hb, g/dL < 10.5 10 86 50 85.3 10.42 98.04 > 10.5 10 499 MCV, fL < 80 16 66 80 88.72 19.51 99.24 > 80 4 519 MCH, pg < 27 16 65 80 88.89 19.75 99.24 > 27 4 520 RBC Count, million/mm3 > 5 7 30 35 94.87 18.92 97.71 < 5 13 555 BTT, β-thalassemia trait; MCH, mean corpuscular hemoglobin; MCV, mean corpuscular volume. Table 2. Distribution of Women Based on Hemoglobinopathy Trait Hemoglobinopathy Trait Pregnant Women, n (%) β-Thalassemia Trait 20 (66.7) δβ-Thalassemia Trait 4 (13.3) HbFH Trait 2 (6.7) HbD Trait 2 (6.7) Sickle Cell Trait 1 (3.3) HbE Trait 1 (3.3) Table 3. A Comparison of Mean Values of Hematologic Parameters Between Women With and Without BTT Hematologic Parameter BTT (n = 20) Non-BTT (n = 585) P Value Mean Hb, g/dL 10.31 ± 1.39 11.52 ± 1.56 < .001 Mean MCV, fL 67.50 ± 13.31 83.91 ± 8.65 < .001 Mean MCH, pg 23.26 ± 4.08 27.78 ± 3.39 < .001 Mean MCHC, g/dL 31.45 ± 2.14 32.87 ± 1.33 .008 Mean RBC Count, million/mm3 4.73 ± 0.61 4.17 ± 0.54 .001 Mean RDW, % 14.43 ± 2.06 14.05 ± 2.53 .433 BTT, β-thalassemia trait; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; MCV, mean corpuscular volume; RDW, red cell distribution width. differences in the mean values of the hematologic parameters analyzed, except for mean red blood cell width. Table 4 presents the diagnostic accuracy of the hematologic parameters evaluated in the BTT and nonBTT groups. Original Article Sampagar A, et al. Feasibility and Cost Analysis of Antenatal Screening and Diagnosis of Hemoglobinopathies
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