Abstract
Iron deficiency anemia is common problem during pregnancy. Red cell size variation (anisocytosis) is the earliest morphologic changes in iron deficiency anemia. Red cell distribution width is a quantitative measure of red cell size variation and it can give the idea of early iron deficiency before other test to become positive. 190 pregnant women were included in this study. Red cell distribution width was compared between iron deficient & non-iron deficient pregnant women. Red cell distribution width also compared with Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film in prelatent iron deficiency, latent iron deficiency, mild and moderate iron deficiency anemia. Red cell distribution width had sensitivity 82.3% and specificity 97.4%. Whereas Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film all had 56.6%, 29.2%, 68.1%, 15% and 38.9% sensitivity but specificity was 90.9%, 98.7%, 83.1%, 96.1% and 98.7% in the detection of iron deficiency. Red cell distribution width appears to be a reliable and useful parameter for detection of iron deficiency during pregnancy.
Highlights
Anemia is a common problem during pregnancy and it affects 25% to 50% of the world population and 50% of pregnant women[1]
Sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of Red cell distribution width (RDW), unpaired t test, Chi square test and ANOVA test were calculated in diagnosing iron deficiency anemia
RDW compared with Hb level, MCV, MCH, MCHC and Peripheral Blood Film (PBF) in prelatent iron deficiency, latent iron deficiency, mild and moderate Iron deficiency anemia (IDA)
Summary
Anemia is a common problem during pregnancy and it affects 25% to 50% of the world population and 50% of pregnant women[1]. RDW can give the idea of early changes in RBC, which is accompanied in iron deficiency anemia[2]. Women can be benefited by doing CBC including RDW for the diagnosis of early iron deficiency. CBC is advised by the physician to all pregnant women for their antenatal checkup, which is less costly than iron profile. Physician can get the idea of early iron deficiency from RDW by advising CBC as a simple test. Red cell indices (MCV, MCH and MCHC) are mean value, which cannot express the small variation of red cells size, which is accompanied in early iron deficiency[4]. As anisocytosis is less prominent in pregnancy and in early iron deficiency anemia, Peripheral Blood Film (PBF) examination gives less information though it needs expert’s opinion[3,8]. Though serum ferritin is gold standard for iron deficiency anemia but it is costly, may give misinterpretation due to physiological reduction and falsely elevated as an acute phase reactant[3]
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