Maternal packed cell volume, anemia severity, and placental hematologic lesions in HIV-positive and HIV-negative pregnancies: A comparative clinicopathologic study

Abstract

Objectives: Anemia is a major contributor to maternal and perinatal morbidity in pregnancy, particularly among women living with human immunodeficiency virus (HIV), yet integrated data on average maternal packed cell volume (PCV), anemia severity, and HIV disease stage remain limited. This study compared blood group, Rhesus status, genotype, mean PCV, anemia prevalence and severity, and placental hematologic features of mothers, and assessed associations of PCV with maternal age, parity, nutritional status, HIV stage, and placental hematologic lesions. Material and Methods: This comparative clinicopathologic study included 145 pregnant women (96 HIV-negative, 49 HIV-positive). The mean PCV was calculated per subject using available measurements. Anemia was defined as PCV <30% and graded as mild (27–29%), moderate (19–26%), or severe (<19%). Maternal age was categorized as <35 or ≥35 years, and nutritional status as normal weight, overweight, or obese. Placental hematologic lesions and adherent clot size were histologically assessed. Non-parametric and categorical statistical tests were applied. Results: HIV-positive mothers had significantly lower mean PCV than HIV-negative mothers (31.9% vs. 33.7%, P ≈ 0.02) and a higher anemia prevalence (23.4% vs. 6.9%, P = 0.006). Anemia severity differed significantly by HIV status and worsened with advancing HIV stage ( P < 0.01). Nutritional status was associated with mean PCV ( P ≈ 0.009), whereas maternal age and parity were not. Mean PCV and anemia showed no significant association with placental hematologic lesions or clot size. Conclusion: HIV infection, particularly advanced disease stage, is strongly associated with reduced mean PCV and greater anemia severity in pregnancy, while placental hematologic lesions are not reliably predicted by maternal PCV.