Role of Red Cell Distribution Width in Late-onset Preeclampsia: A Single-Center Experience

Nori, Wassan; Raad Helmi, Zeena; Farhan Salman, Alea; H. Hameed, Ban

doi:10.33091/amj.2023.138711.1041

	Role of Red Cell Distribution Width in Late-onset Preeclampsia: A Single-Center Experience
Al- Anbar Medical Journal
Volume 20, Issue 1, June 2024, Pages 19-24 PDF (709.45 K)
Document Type: Original articles
DOI: 10.33091/amj.2023.138711.1041
Authors
Wassan Nori^* ¹; Zeena Raad Helmi¹; Alea Farhan Salman²; Ban H. Hameed¹
¹Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
²National Center of Hematology, Mustansiriyah University, Baghdad, Iraq
Abstract
Background: Red cell distribution width (RDW) is an inflammatory biomarker and a component of complete blood count that gains increased attention. Pre-eclampsia (PE) is a unique pregnancy syndrome for which inflammation was proposed for pathogenesis. Objective: We aimed to examine RDW's role in PE and explore confounders that limit its implication in practice. Materials and Methods: A case-control study recruited 120 participants matched in body mass index (BMI) and gestational age into 3 subgroups; late-onset severe PE cases (30/120), late-onset non-severe PE cases (30/120), and healthy controls (60/120). Participants' demographics (age, BMI, systolic and diastolic blood pressure (SBP, and DBP), hematological and biochemical parameters were evaluated. Results: RDW was significantly higher in PE cases (P-value < 0.01 ); In addition, RDW was positively correlated to SBP, DBP, and protein urea, r =0.5, r = 0.46, and r = 0.47 ; P-value < 0.0001, respectively. Liver enzymes, hemoglobin, and white blood cell count were all significantly linked to RDW (r = 0.27, P-value = 0.015), (r = 0.32, P-value = 0.005), (r = -0.27, P-value = 0.02) and (r = 0.39; P-value = 0.0004) respectively. Applying ROC Curve analysis showed that RDW cut-off value of > 14.4% discriminated PE cases from healthy controls (P-value < 0.001). At a cut-off value > 15.6% RDW distinguished severe from non-severe PE cases (P-value < 0.001). Conclusion: RDW was significantly correlated to PE predictors and severity markers independent of gestational age and BMI. The ROC curve showed that RDW distinguished PE from healthy controls in addition to non-severe from severe PE cases with high sensitivity and specificity. Being an inexpensive, reliable test with good predictive and prognostic value warrants further studies for RDW's role in PE screening and follow-up.
Keywords
Red cell distribution width; Late-onset pre-eclampsia; Body mass index; Diagnostic performance; Severity

References
[1] M. P. Rambaldi, E. Weiner, F. Mecacci, J. Bar, and F. Petraglia, “Immunomodulation and preeclampsia,” Best Pract. Res. Clin. Obstet. Gynaecol., vol. 60, pp. 87–96, 2019. [2] W. Nori, R. M. Hamed, A. B. Roomi, and W. Akram, “Alpha-1antitrypsin in pre-eclampsia; from a clinical perspective,” J Pak Med Assoc, vol. 71, no. 12, pp. S53-56, 2021. [3] M. K. Jena, N. R. Sharma, M. Petitt, D. Maulik, and N. R. Nayak, “Pathogenesis of preeclampsia and therapeutic approaches targeting the placenta,” Biomolecules, vol. 10, no. 6, p. 953, 2020. [4] A. C. Harmon et al., “The role of inflammation in the pathology of preeclampsia,” Clin. Sci., vol. 130, no. 6, pp. 409–419, 2016. [5] T. O. Bueno-Pereira et al., “Markers of endothelial dysfunction are attenuated by resveratrol in preeclampsia,” Antioxidants, vol. 11, no. 11, p. 2111, 2022. [6] G. L. Salvagno, F. Sanchis-Gomar, A. Picanza, and G. Lippi, “Red blood cell distribution width: a simple parameter with multiple clinical applications,” Crit. Rev. Clin. Lab. Sci., vol. 52, no. 2, pp. 86–105, 2015. [7] I. Adam, T. K. Mutabingwa, and E. M. Malik, “Red cell distribution width and preeclampsia: a systematic review and meta-analysis,” Clin. Hypertens., vol. 25, pp. 1–8, 2019. [8] C. Liu et al., “Higher Preoperative Red Blood Cell Distribution Width Increases the Risk of Myocardial Injury After Noncardiac Surgery in Advanced-Age Patients: A Retrospective Cohort Study,” Clin. Interv. Aging, pp. 169–179, 2023. [9] and H. J. A. A.-B. W. Nori, S. K. Harmoosh, “Can Red cell distribution width screen for metabolic abnormality in women with Polycystic Ovarian Syndrome?,” J. Med. Investig., vol. 69, no. 3.4, pp. 191–195, 2022. [10] P.-F. Wang, S.-Y. Song, H. Guo, T.-J. Wang, N. Liu, and C.-X. Yan, “Prognostic role of pretreatment red blood cell distribution width in patients with cancer: A meta-analysis of 49 studies,” J. Cancer, vol. 10, no. 18, p. 4305, 2019. [11] H. H. Patel, H. R. Patel, and J. M. Higgins, “Modulation of red blood cell population dynamics is a fundamental homeostatic response to disease,” Am. J. Hematol., vol. 90, no. 5, pp. 422–428, 2015. [12] H. Abdullahi, A. Osman, D. A. Rayis, G. I. Gasim, A. M. Imam, and I. Adam, “Red blood cell distribution width is not correlated with preeclampsia among pregnant Sudanese women,” Diagn. Pathol., vol. 9, no. 1, pp. 1–5, 2014. [13] X. Chen et al., “Is RDW a clinically relevant prognostic factor for newly diagnosed multiple myeloma? A systematic review and meta-analysis,” BMC Cancer, vol. 22, no. 1, p. 796, 2022. [14] J. J. M. L. Hoffmann, K. C. A. M. Nabbe, and N. M. A. van den Broek, “Effect of age and gender on reference intervals of red blood cell distribution width (RDW) and mean red cell volume (MCV),” Clin. Chem. Lab. Med., vol. 53, no. 12, pp. 2015–2019, 2015. [15] T. S. Nanjundeswaraswamy and S. Divakar, “Determination of sample size and sampling methods in applied research,” Proc. Eng. Sci., vol. 3, no. 1, pp. 25–32, 2021. [16] A. Wojtowicz, M. Zembala-Szczerba, D. Babczyk, M. Kołodziejczyk-Pietruszka, O. Lewaczyńska, and H. Huras, “Early-and late-onset preeclampsia: a comprehensive cohort study of laboratory and clinical findings according to the new ISHHP criteria,” Int. J. Hypertens., vol. 2019, 2019. [17] Z. V. Yılmaz, E. Yılmaz, and T. Küçüközkan, “Red blood cell distribution width: A simple parameter in preeclampsia,” Pregnancy Hypertens. An Int. J. Women’s Cardiovasc. Heal., vol. 6, no. 4, pp. 285–287, 2016. [18] S. G. Reddy, H. Kumar, G. Nagaraj, and P. P. Kottur, “Red cell distribution width as a marker of preeclampsia severity,” J. Evol. Med. Dent. Sci., vol. 5, no. 48, pp. 3104–3108, 2016. [19] W. Sen‐yu and X. Chao, “Assessment of the relationship between red blood cell distribution width and preganecy hypertension disease,” J. Obstet. Gynaecol. Res., vol. 42, no. 10, pp. 1258–1262, 2016. [20] A. Tanindi, F. E. Topal, F. Topal, and B. Celik, “Red cell distribution width in patients with prehypertension and hypertension,” Blood Press., vol. 21, no. 3, pp. 177–181, 2012. [21] E. Çintesun, F. N. I. Çintesun, H. Ezveci, F. Akyürek, and Ç. Çelik, “Systemic inflammatory response markers in preeclampsia,” J. Lab. Physicians, vol. 10, no. 03, pp. 316–319, 2018. [22] N. Morisaki et al., “Maternal blood count parameters of chronic inflammation by gestational age and their associations with risk of preterm delivery in the Japan Environment and Children’s Study,” Sci. Rep., vol. 11, no. 1, p. 15522, 2021. [23] P. Paliogiannis et al., “Red blood cell distribution width in pregnancy: a systematic review,” Biochem. medica, vol. 28, no. 3, pp. 389–398, 2018. [24] M. S. Beksac, A. Tanacan, G. Ozten, and A. N. Cakar, “Low-dose low-molecular-weight heparin prophylaxis against obstetrical complications in pregnancies with metabolic and immunological disorder-associated placental inflammation,” J. Matern. Neonatal Med., vol. 35, no. 8, pp. 1546–1553, 2022. [25] P. Gutaj et al., “The role of the adipokines in the most common gestational complications,” Int. J. Mol. Sci., vol. 21, no. 24, p. 9408, 2020. [26] F. S. Farhan, W. Nori, I. T. A. Al Kadir, and B. H. Hameed, “Can fetal heart lie? Intrapartum CTG changes in COVID-19 mothers,” J. Obstet. Gynecol. India, vol. 72, no. 6, pp. 479–484, 2022. [27] R. M. Al-Ani, “Ear, nose, and throat manifestations of COVID-19 and its vaccines,” World J. Clin. Cases, vol. 10, no. 25, p. 8808, 2022.
Statistics Article View: 1,581 PDF Download: 708