ABO-Rhesus Blood Group Distribution among Peri-Partum Cardiomyopathy Patients: A Multi-Center Study in Sokoto, Nigeria

Abstract

Background: Cardiovascular disease is a major cause of death among women of child bearing age in Northern Nigeria. As much as 60% of Peripartum Cardiomyopathy (PPCM) was reported among women with heart failures in a tertiary health institution in Sokoto, Northwestern Nigeria and was responsible for about 34% of deaths in peripartum women in South Africa. The Millennium and Sustainable Development Goals (MDG & SDG) 2000 to 2015 and 2015 to 2030, respectively have it as their cardinal quests, to reduce maternal deaths ratio by three quarter by the year 2030. Studies have identified the risk factors of cardiovascular diseases among women in their reproductive age and a study had observed that cardiovascular diseases may be partly explained by blood group polymorphism, but none to our knowledge has considered the possible association of the various sub-classes of ABO-Rhesus blood group and PPCM. Consequently, the present study assessed the distribution of the different ABO-Rh groups among ninety patients diagnosed with PPCM from three centres in Sokoto metropolis. Methods: Records from ninety (90) consecutive consenting patients were analyzed for this study. Data included were demographic, Clinical, Electrocardiographic and Echocardiographic. Data analysis was carried out using IBM SPP software. Values were expressed as mean ± standard deviation (SD), as well as tables of frequencies. Where relationships for non-parametric data were sought, chi-square goodness of fit was estimated. Single factor ANOVA was used to determine difference in means among the different blood groups, using Microsoft excel. P-value of ≤ 0.05 was considered statistically significant. Results: The mean age of the study participants was 27.2 ± 8.2 years, with range 17 45 years. About 55.1% of the patients enrolled in the study are of Blood group B, Blood group O constitute 30.8%, while groups A and AB form a paltry 14.1% of the study population (χ2 = 52.99, P < 0.0001, df = 3). About 86.6% of the patients had ejection fraction (EF) below 45%, with mean value of 36.70 ± 7.52%. Mean EFs for the groups were 35.46 ± 8.05, 37.09 ± 8.12, 36.00 ± 4.36 and 36.98 ± 6.81 for A, B, AB and O respectively (F = 0.1399, Fcrit = 2.7159, df = 3, P = 09358). 93.3% of the *Corresponding author: Hayatu Umar, MBBS, MSc, FWACP, Department of Internal Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, Tel: +2348095100566 ISSN: 2378-2951 DOI: 10.23937/2378-2951/1410182 Umar et al. Int J Clin Cardiol 2020, 7:182 • Page 2 of 9 • Earlier studies made efforts to identify the risks factors for cardiac diseases in the reproductive age, including a study that showed association between ABO blood groups and the risk of CAD [7,10]. An individual may have type A, type B, type O, or type AB blood group and this arise from inheriting one or more of the alternative 3 main alleles two codominant (A and B) and one recessive (O) [12]. The role of ABO blood group antigens in the aetiopathogenesis of various cardiovascular diseases is a fascinating subject and may serve as impetus for developing novel strategies for possible reduction of global burden of cardiovascular diseases in the near future. Consequently, the present study determined the distribution of ABO-Rhesus blood group classes among PPCM patients in Sokoto, North-Western Nigeria and observed differences in the distributions in the national average and from local data among female populations.