The Association of ABO RH Typing and von Willebrand Factor Levels in Reproductive-Aged Women with Abnormal Bleeding Tendencies: A Case-Control Study in Ghana

Background: Reproductive-aged women often experience bleeding episodes such as heavy menstrual bleeds, abnormal uterine bleeds, post-partum bleeds, and epistaxis, which may threaten their well-being. The presence of an underlying bleeding disorder such as von Willebrand disease (vWD) may aggravate the situation. ABO blood group has been known to influence the levels of vWF but the mechanism is not fully understood. This study was aimed at determining the association of vWF and ABO RH blood groups among these reproductive-aged women with abnormal bleeding episodes.

Materials and Methods: This was a case-control study involving 90 women of reproductive age: 30 with history of abnormal bleeding and 60 controls. Venous blood sample was collected for ABO Rh blood typing, complete blood count (CBC) analysis and plasma vWF level determination. The data was captured with Microsoft excel version 2016 and analysis done with SPSS version 26. Statistical significance was set at P<0.05.

Results: The vWF antigen level in participants with a bleeding history were lower than that of those without a bleeding history (p= 0.002). The blood group with the highest distribution among the study population was O Rh (D) positive. Blood group B Rh (D) positive recorded significantly higher levels Ag level of vWF (p=0.032).

Conclusion: Plasma vWF levels in the study subjects were determined to be influenced by their ABO blood group antigens. Persons with blood group O recorded the lowest levels of vWF. The differences in vWF levels among the A, B, and AB blood groups were statistically insignificant. Reproductive-aged women with a history of abnormal bleeding had significantly lower levels of vWF antigen, as well as those on contraceptive medications.

Keywords: Bleeding Tendencies, Von Willebrand Factor, Blood Group, Reproductive-Aged Women.