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

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. Objectives: 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.