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    Profile of Rheumatoid Factor in Pregnant Women at The University Hospital Center For Mother and Child (Chu-Me)

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    Rheumatoid Arthritis (RA) is the most common chronic inflammatory rheumatism, predominantly affecting women. The general objective of our study is to contribute to the management of pregnant women with RA at CHU-ME in N'Djamena.

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    Profile of Rheumatoid Factor in Pregnant Women at The University Hospital Center For Mother and Child (Chu-Me)

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    Rheumatoid Arthritis (RA) is the most common chronic inflammatory rheumatism, predominantly affecting women. The general objective of our study is to contribute to the management of pregnant women with RA at CHU-ME in N'Djamena.

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    Profile of Rheumatoid Factor in Pregnant Women at the University Hospital Center for Mother and Child (Chu-me)

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    Rheumatoid Arthritis (RA) is the most common chronic inflammatory rheumatism, predominantly affecting women. The general objective of our study is to contribute to the management of pregnant women with RA at CHU-ME in N'Djamena.

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    © All Rights Reserved
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    2 views4 pages

    Profile of Rheumatoid Factor in Pregnant Women at The University Hospital Center For Mother and Child (Chu-Me)

    Uploaded by

    Scivision Publishers
    Rheumatoid Arthritis (RA) is the most common chronic inflammatory rheumatism, predominantly affecting women. The general objective of our study is to contribute to the management of pregnant women with RA at CHU-ME in N'Djamena.

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    © All Rights Reserved
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    of 4

    Research Article ISSN 2639-8486

    Research Article Clinical Immunology & Research

    Profile of Rheumatoid Factor in Pregnant Women at the University Hospital


    Center for Mother and Child (Chu-Me)
    Tariam Djibangar Agnes, Ahmat Azarak Mahamat*, Ali Mahamat Moussa, Bessimbaye Nadalaou,
    Mayana Habkreou, Abakar Tadjadine Goudra, Bakaranga-Via Issakou, Mahamat Nadjib and
    Abdelsalam Tidjani

    National Reference University Hospital Laboratory (CHU-


    1

    RN), Chad. *
    Correspondence:
    Tariam Djibangar Agnès, National Reference University Hospital
    Faculty of Human Health Sciences, University of Ndjamena,
    2
    Laboratoire (CHU-RN), Chad.
    Chad.
    Received: 21 Jun 2024; Accepted: 07 Sep 2024; Published: 18 Sep 2024
    3
    University Center for Mother and Child (CHU-ME), Chad.

    Citation: Agnes TD, Mahamat AA, Moussa AM, et al. Profile of Rheumatoid Factor in Pregnant Women at the University Hospital
    Center for Mother and Child (Chu-Me). Clin Immunol Res. 2024; 8(2): 1-4.

    ABSTRACT
    Introduction: Rheumatoid Arthritis (RA) is the most common chronic inflammatory rheumatism, predominantly
    affecting women. The general objective of our study is to contribute to the management of pregnant women with RA
    at CHU-ME in N'Djamena.

    Materials and Methods: This prospective study analyzed the Rheumatoid Factor (Latex Test) in 60 parturients at
    the prenatal consultation (CPN) of CHU-ME from January 1st to March 31st, 2024. The serological analysis of the
    RF was determined by an agglutination test on a slide. The variables studied were sociodemographic, clinical, and
    biological. Results were expressed in average, percentage with standard deviation.

    Results: Out of 60 samples analyzed, we identified 3 cases of RF positivity in pregnant women showing a rate of 5%.
    The average age of parturients was 22 years old, ranging from 18 to 40. Most pregnant women had a secondary
    education level (40%), and 91.66% resided in urban areas. Multiparous women represented 75%, from whom most
    of them shows no clinical signs (60%) or medical history (91.66%).

    Conclusion: RF is a preventive factor against the progression to more severe stages of RA, contributing to the
    reduction of prenatal mortality risks.

    Keywords is a complex multifactorial disease resulting from genetic,


    Rheumatoid Arthritis, Rheumatoid Factor, Pregnancy, CHU-ME, environmental, hormonal, and immunological factors [3].
    Chad.
    The influence of hormonal status in RA is well established, as
    Introduction evidenced by the predominance of the disease in women (75% of
    Rheumatoid Arthritis (RA) is a very heterogeneous chronic cases). It is therefore not surprising that pregnancy is a risk factor
    inflammatory disease and the most common chronic inflammatory for women with RA [4]. In the past, pregnancy was discouraged
    rheumatism. It can occur at any age, but it is mostly observed in women with RA due to the high risk of maternal and fetal
    between 40 and 50 years old [1]. It is a systemic chronic morbidity and mortality [5]. Currently, thanks to advancements in
    autoimmune disease characterized by the inflammation of the RA management and a better understanding of maternal-fetal risks,
    synovial joints, leading to joint destruction and deformation. pregnancy is largely allowed [5], but provided that it is considered
    First described by Alfred Baring Garrod in the 1800s [2], RA as a "high-risk pregnancy" requiring close collaboration between

    Clin Immunol Res, 2024 Volume 8 | Issue 2 | 1 of 4


    the patient and healthcare providers to ensure the best possible 2. Positive RF Control Serum (human origin).
    outcomes. 3. Negative RF Control Serum (human origin).
    4. Reusable agglutination slide and single-use pipette.
    In Chad, no data on the prevalence of RA in pregnant women
    were mainly found. That is the reason why we were prompted to Storage: Store at 2-8°C, protected from light; do not freeze the
    conduct this study aiming at contributing to the management of Latex Reagent.
    pregnant women with RA.
    Procedure
    Materials and Methods 1. Bring each component to room temperature.
    This prospective analytical study was conducted from January 1st 2. Place one drop of positive control on one circle of the slide
    to March 31st, 2024, over a period of 3 months. The study was and one drop of negative control on another circle.
    conducted in accordance to ethical principles established by 3. Using a provided single-use pipette, place one drop of the
    the Ministry of Public Health of Chad for good clinical research specimen on another circle of the test slide.
    practices. It was conducted at the University Center for Mother and 4. Resuspend the Latex reagent by inversion.
    Child (CHU-ME) in the prenatal consultation (CPN) service. Patients 5. Add one drop of the Latex reagent next to each control and
    were recruited based on a pre-established inquiry form containing specimen drop.
    questionnaires and studied variables, with information collected 6. Mix the preparation using a single-use pipette over the entire
    through interviews. Analyses were performed in the immunology circle surface.
    laboratory of the University Center for Mother and Child. Nevertheles 7. Gently rock the slide for 2 minutes and observe agglutination
    the study obtained informed consent from the pregnant women. in the test circles.
    8. Finally, clean the slide with demineralized water and air dry.
    Study Population
    Our study population consisted of pregnant women attending
    prenatal consultations. Inclusion criteria were pregnant women
    with or without RA who agreed to participate to the study. Non-
    inclusion criteria were non-pregnant women with RA and pregnant
    women who refused to participate to the study. Variables studied
    included sociodemographic, clinical, and biological parameters.

    Blood Sampling
    Blood was drawn by puncturing a peripheral vein into a dry tube.

    Methodology
    The methodology for performing the tests included three phases:

    Pre-analytical Phase Legend: Negative reaction (circles 1 and 2); Positive (circle 3)
    This included all conditions implemented before testing, such Picture 1: Rheumatoid Factor Latex Test.
    as withdrowing blood from patients and sending the samples to
    the laboratory. Proper procedures included wearing a clean lab Biological Parameter
    coat, washing hands, wearing gloves, cleaning the workspace, ◊ The Rheumatoid Factor
    identifying and recording tubes in the bench log. The prevalence of RA in pregnant women is 5%.

    Sample Collection 5%
    Blood was collected from the elbow fold (or the back of the hand (n=3)

    in case of difficulty). Samples were centrifuged at 3000 RPM for 5


    minutes upon arrival at the laboratory.

    Analytical phase
    This involved performing the Rheumatoid Factor analysis using
    the agglutination test. 95 %
    (n=57)

    Used Reagents
    1. Rheumatoid Factors (RF) - Latex Slide Test Ref 31013 lot Positive
    Négative
    42185: a suspension of polystyrene particles coated with
    gamma globulins. Picture 2: Prevalence of RA in Pregnant Women.

    Clin Immunol Res, 2024 Volume 8 | Issue 2 | 2 of 4


    Sociodemographic Characteristics of Patients Patients with no medical history represented 91.66%. Rheumatism
    ◊ Residence was the most found medical history in 8.34%.
    Patients residing in urban areas were the most represented at 91.66%.
    ◊ Clinical Signs
    8 ,34% (n=5)
    91, 66%(n:55) Table 5: Division of Patients by Clinical Signs.
    Clinical Signs n %
    Joint pain and fever 7 11,67
    Joint pain 7 11,67
    Urban
    Joint swelling 0 0
    Provincial Fever 10 16,66
    None 36 60
    Total 60 100

    60% of the patients had no clinical signs. Fever was the most
    common clinical sign in 16.66% of cases.
    Picture 3: Division of Patients by Residence.
    Statistical Analysis
    ◊ Age Data entry was performed using Microsoft Excel®. Statistical
    Table 1: Division of Patients by Age. analysis was conducted using Epi Info® 2008 (version 3.5.1).
    Age (years) n % Comparisons between different variables were made using non-
    18-25 28 46,66 parametric Mann Whitney and Kruskal-Wallis tests. A p-value of
    26-35 24 40 0.05 was considered the threshold for significance.
    36-40 8 13,34
    Total 60 100 Ethical Considerations
    The inquiry was conducted after obtaining informed and written
    In this study, the most represented age group was 18-25 years old, consent from the patients. Anonymity and confidentiality of the
    with a rate of 46.66%. The average age is 22 years with extremes obtained information were guaranteed.
    of 18 to 40 years.
    Results
    ◊ Educational Level In our study, we recorded 60 pregnant women, with a prevalence
    Table 2: Division of Patients by Educational Level.
    rate of 5%. Urban residents constituted the majority, that is to say
    Educational Level n %
    Primary 6 10
    91.66%. Women aged 18-25 years years had a representation rate
    Secondary 24 40 of 46.66%, with an average age of 22 years old, ranging from 18
    Higher Education 9 15 to 40 years. According to the education level, 40% had secondary
    Unschooled 21 35 education, and multiparous women were the most represented at
    Total 60 100 75%.
    The majority of patients had secondary education with a frequency In terms of medical history, 91.66% of the patients had no prior
    of 40%, followed by unschooled patients at 35%. medical history, and fever was the most dominant clinical sign at 60%.
    Clinical Characteristics of Patients
    Discussion
    ◊ Parity
    Prevalence of Rheumatoid Arthritis
    Table 3: Division of Patients by Parity.
    Only RF serology by LATEX test (Biosystems) was our biological
    Parity n %
    parameter. We recorded three (03) positive cases of RF by slide
    Primiparous 15 25
    Nulliparous 0 0
    agglutination test, a prevalence rate of 5%, with 95% of cases
    Multiparous 45 75 being RF seronegative. Our results matched the data reported by
    Total 60 100 BERRICHI Celia et al. in Algeria in 2022 [6] and Sabrine S. [1].
    In this study, 75% of the patients were multiparous. With a specificity of 65-85% and sensitivity of 60-80%, RF (Latex
    Test) [1], RF can be found in other rheumatic or inflammatory
    ◊ Medical History diseases, as it is not specific to RA. During pregnancy, there is an
    Table 4: Division of Patients by Medical History. increase in the production of gonadal (estrogen and progesterone)
    Medical History n % and adrenal (cortisol) sex steroids throughout pregnancy [7].
    Rheumatic 5 8.34
    Inflammatory 0 0 Sociodemographic Characteristics of Patients
    None 55 91.66 In our study, pregnant women aged from 18-25 represented
    Total 60 100 46.66%, followed by those aged from 26-35 (40%) and 36-40

    Clin Immunol Res, 2024 Volume 8 | Issue 2 | 3 of 4


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    © 2024 Agnes TD, et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License

    Clin Immunol Res, 2024 Volume 8 | Issue 2 | 4 of 4

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