An evaluation of red blood cell heterogeneity (increased red blood cell distribution width) in iron deficiency of pregnancy

Osborne, Pamela T.; Burkett, Luther L.; Ryan, George M.; Lane, Marlene

doi:10.1016/0002-9378(89)90438-9

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…20 Uchida, 1989 also found normal Hb level with increased RDW in latent ID and reduced Hb level with increased RDW in IDA. 13 In early ID without anemia and IDA was infrequently identified by increased level of RDW by Osborne et al 7 He also found RDW was increased in 4 out of 24 womens of ID without anemia and 15 out of 49 womens with anemia. In the present study MCV had sensitivity 29.2% and specificity 98.7% for diagnosis of iron deficiency.…”

Section: Discussionmentioning

confidence: 92%

“…6 Early ID only has high RDW because early ID is not associated with anemia or microcytosis. 7 In prelatent and latent ID, haemoglobin concentration and MCV are normal. 8 But in latent ID, RDW would be expected to increase because a microcytic population of cells appears in the blood.…”

Section: Introductionmentioning

confidence: 99%

“…8 But in latent ID, RDW would be expected to increase because a microcytic population of cells appears in the blood. 7,9 RDW increases at minimum four weeks before MCV, thus leads to early detection of ID. 8 RDW also increases before hemoglobin concentration falls.…”

Section: Introductionmentioning

confidence: 99%

“…7,9 During normal pregnancy the serum iron, percentage saturation and total iron binding capacity (TIBC) have less diagnostic value because during this period serum iron and percentage saturation falls and TIBC increases in an iron replete women like ID. 5,7 Serum ferritin is the gold standard for diagnosing IDA but it is costly, may give misinterpretation due to physiological reduction during normal pregnancy and falsely elevated as an acute phase reactant. 2 RDW is less explored in Bangladesh but Uddin et al showed the value of RDW as a diagnostic tool in IDA and various congenital haemoglobin disorders.…”

Section: Introductionmentioning

confidence: 99%

“…ROC of Hb, MCV and RDW for prediction of ID al 17 also found increased RDW with reduced MCV in 23 subjects out of 48 iron deficient patients. Osborne et al7 found RDW was increased in 7 patients with normal MCV. RDW was abnormal in 26% women and MCV was abnormal in 24% patient.…”

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confidence: 96%

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Prediction of Iron Deficiency by Red Cell Distribution Width, Mean Corpuscular Volume and Haemoglobin Concentration in Pregnant Women

et al. 2019

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Background: Red cell distribution width (RDW) is a routine parameter in fully automated hematology auto analyzer, can give the idea of iron deficiency before haemoglobin and mean corpuscular volume in early iron deficiency or latent stage. Patient can be benefited by doing complete blood count including RDW for the diagnosis of early iron deficiency as a cheaper test than iron profile. This study was aimed to predict early iron deficiency by RDW, mean corpuscular volume and haemoglobin concentration in pregnant women. Methods: In this study, 190 pregnant women were included from Gynae and Obstetric outdoor of Bangabandhu Sheikh Mujib Medical University from august 2008-2009. Complete blood count including haemoglobin percentage, mean corpuscular volume and RDW and iron profile were done. RDW was compared with haemoglobin concentration and mean corpuscular volume in various stages of iron deficiency. Results: RDW was more significant than haemoglobin concentration in latent iron deficiency when haemoglobin level was normal (p<0.05). In mild and moderate iron deficiency anemia, RDW was increased progressively though haemoglobin level was reduced. RDW was more significant than mean corpuscular volume level in latent iron deficiency, mild and moderate iron deficiency anemia. The difference of mean corpuscular volume and RDW was statistically significant (p<0.05) in latent iron deficiency, mild iron deficiency anaemia and moderate iron deficiency anaemia (p value of 0.001, 0.001 and 0.011). In this study RDW had sensitivity 82.3% and specificity 97.4%. haemoglobin concentration and mean corpuscular volume had sensitivity 56.6% and 29.2 % and specificity 90.9% and 98.7 % respectively. Based on the receiver-operator characteristic (ROC) curves RDW had the best area (0.925) under curve compared to haemoglobin and mean corpuscular volume. Conclusion: Latent iron deficiency without other existing disease like haemoglobinopathy, early folate / vit B12 deficiency could be predicted early by increased RDW when haemoglobin concentration and mean corpuscular volume were normal. Birdem Med J 2019; 9(2): 111-116

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