Impact of Malaria Infection on Red Blood Cell Parameters among Pregnant Women in Southeastern Nigeria

Abstract

Background: Malaria in pregnancy is a major public health concern in sub-Saharan Africa, contributing to maternal anaemia and adverse fetal outcomes. Alterations in erythrocyte parameters reflect both the direct effects of Plasmodium infection and pregnancy-related haematological changes. However, data on the impact of malaria on red blood cell indices in Southeastern Nigeria remain limited. Objective: To evaluate the effect of malaria infection on erythrocyte indices among pregnant women in Owerri, Nigeria, and compare these parameters with malaria-negative pregnant women and non-pregnant healthy controls. Methods: A cross-sectional comparative study was conducted among 150 women, divided into three groups of 50: malaria-positive pregnant women (MP+), malaria-negative pregnant women (MP−), and non-pregnant controls. Venous blood samples were collected and analyzed for haemoglobin concentration (Hb), packed cell volume (PCV), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), and red cell distribution width (RDW) using an automated haematology analyzer. Malaria status was confirmed by microscopy and rapid diagnostic tests. Data were analyzed using descriptive statistics, Student’s t-test, and one-way ANOVA, with significance set at p < 0.05. Results: Malaria-positive pregnant women exhibited significantly lower Hb (10.01 ± 1.05 g/dL), PCV (30.05 ± 3.12%), and RBC counts (4.02 ± 0.41 ×10¹²/L) compared with malaria-negative pregnant women (Hb: 10.54 ± 1.02 g/dL; PCV: 31.72 ± 3.48%; RBC: 4.16 ± 0.44 ×10¹²/L) and non-pregnant controls (Hb: 12.25 ± 1.41 g/dL; PCV: 36.78 ± 4.51%; RBC: 4.67 ± 0.56 ×10¹²/L) (p < 0.001). Significant differences were also observed in MCV and MCH, while MCHC and RDW showed no statistically significant variation across groups. Post-hoc analyses indicated that reductions in Hb, PCV, and RBC were most pronounced in malaria-infected pregnant women. Conclusion: Malaria infection during pregnancy significantly alters erythrocyte parameters, particularly Hb, PCV, RBC, MCV, and MCH, predisposing pregnant women to anaemia and associated complications. These findings highlight the need for routine haematological monitoring and effective malaria prevention and management strategies in endemic regions to improve maternal and fetal outcomes.