TRIMESTER-SPECIFIC MATERNAL ERYTHROCYTE INDICES AS PREDICTORS OF ADVERSE NEONATAL OUTCOMES: A CROSS-SECTIONAL STUDYFROMA HIGH-BURDEN LMIC SETTING
Author(s)
Manmay S. Bhagwat, PharmD1, Haritha S. Nath, PharmD2, Ruchita Rajesh Ranazunjare, PharmD2, shraddha madhukarrao sawant, PharmD3, Unnati Gupta, PharmD2.
1Student, Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pimpri Chinchwad, India, 2Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pune, India, 3Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, pune, India.
1Student, Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pimpri Chinchwad, India, 2Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pune, India, 3Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, pune, India.
OBJECTIVES: In India, where nearly 88% of pregnant women are anaemic, adverse neonatal outcomes including low birth weight (LBW), preterm birth, and neonatal intensive care unit (NICU) admission impose a disproportionate burden on resource-constrained healthcare systems. Current antenatal care (ANC) relies primarily on haemoglobin (Hb) estimation, which detects anaemia only after iron stores are severely depleted and offers limited predictive value for neonatal morbidity. Erythrocyte indices mean corpuscular haemoglobin concentration (MCHC), mean corpuscular volume (MCV), and mean corpuscular haemoglobin (MCH) are automatically generated within routine complete blood count (CBC) panels at no marginal cost, yet remain systematically underutilised for neonatal risk stratification. This study evaluated whether trimester-specific maternal erythrocyte indices can serve as practical, accessible predictors of adverse neonatal outcomes in a high-burden LMIC antenatal setting.
METHODS: Analytical cross-sectional study of 257 pregnant women in Pune, India (Ethics: IESC/UG/Pharmaceutical/03/2025). Maternal Hb, MCV, MCH, MCHC, and RDW were extracted across three trimesters. Neonatal outcomes (LBW, preterm, SGA, NICU, APGAR) were recorded. Statistical analysis included Spearman correlation and multivariable logistic/linear regression (JMP v11.65).
RESULTS: High morbidity observed: 42.4% LBW, 22.2% preterm, and 70.8% NICU admission; anaemia prevalence 37.7%-42.9%. First-trimester MCHC independently predicted birth weight (β=0.026; p=0.033), LBW (OR=0.847; 95% CI: 0.740-0.968; p=0.016), and SGA (OR=0.859; 95% CI: 0.755-0.970; p=0.011). Third-trimester MCV, MCH, and MCHC independently predicted NICU admission (p<0.05). Second-trimester RDW differentiated birth term categories (p=0.021).
CONCLUSIONS: Trimester-specific erythrocyte indices from routine CBCs demonstrate robust predictive utility for neonatal complications. First-trimester MCHC provides an actionable early risk signal. Requiring no additional cost or infrastructure, their integration into standard ANC offers an equity-aligned strategy for LMIC settings.
METHODS: Analytical cross-sectional study of 257 pregnant women in Pune, India (Ethics: IESC/UG/Pharmaceutical/03/2025). Maternal Hb, MCV, MCH, MCHC, and RDW were extracted across three trimesters. Neonatal outcomes (LBW, preterm, SGA, NICU, APGAR) were recorded. Statistical analysis included Spearman correlation and multivariable logistic/linear regression (JMP v11.65).
RESULTS: High morbidity observed: 42.4% LBW, 22.2% preterm, and 70.8% NICU admission; anaemia prevalence 37.7%-42.9%. First-trimester MCHC independently predicted birth weight (β=0.026; p=0.033), LBW (OR=0.847; 95% CI: 0.740-0.968; p=0.016), and SGA (OR=0.859; 95% CI: 0.755-0.970; p=0.011). Third-trimester MCV, MCH, and MCHC independently predicted NICU admission (p<0.05). Second-trimester RDW differentiated birth term categories (p=0.021).
CONCLUSIONS: Trimester-specific erythrocyte indices from routine CBCs demonstrate robust predictive utility for neonatal complications. First-trimester MCHC provides an actionable early risk signal. Requiring no additional cost or infrastructure, their integration into standard ANC offers an equity-aligned strategy for LMIC settings.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO36
Topic
Clinical Outcomes, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Clinical Outcomes Assessment
Disease
Pediatrics, Reproductive & Sexual Health, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)