Prevalence and Spectrum of Hemoglobinopathies Among Antenatal Women in Gujarat: An HPLC-Based Screening Study at a Tertiary Care Center

Background: Hemoglobinopathies pose a significant public health challenge in India. Antenatal screening is vital for early detection and informed reproductive choices. While traditional complete blood count (CBC) methods lack specificity, High-Performance Liquid Chromatography (HPLC) offers a precise diagnostic tool. This study evaluated HPLC's effectiveness in antenatal females at a tertiary care center in Gujarat. Methods: This retrospective, observational study analyzed data from 484 pregnant women who underwent HPLC screening during their antenatal period at a tertiary civil hospital in Ahmedabad, Gujarat. Inclusion criteria ensured complete demographic, hematological (CBC), and interpretable HPLC results. Data were analyzed using descriptive statistics. Ethical approval with a waiver of informed consent was obtained. Result: Of 484 antenatal women screened, 86 (17.8%) were diagnosed with a hemoglobinopathy. Beta-thalassemia minor was most common (n=62, 72% of positive cases), followed by sickle cell trait (n=14, 16%). Less common findings included HbD Punjab (n=5, 6%), HbE trait (n=2, 3%), and single cases of HbE homozygous, SCD+BT, and delta-beta thalassemia (1% each). Hematological analysis showed elevated HbA2 and microcytosis in beta-thalassemia minor, distinct variant percentages (e.g., HbS 27.82% in sickle cell trait), and varying red cell indices. Conclusion: This study revealed a high prevalence of hemoglobinopathies (17.8%) among antenatal women in Ahmedabad, Gujarat, predominantly beta-thalassemia minor and sickle cell trait. HPLC proved crucial for accurate diagnosis of these diverse variants. The significant carrier burden underscores the urgent need for comprehensive antenatal screening, genetic counseling, and prenatal diagnostic options to reduce severe hemoglobinopathy incidence in India.