CLINICAL UTILITY OF MATERNAL RED CELL DISTRIBUTION WIDTH FOR EARLY RISK STRATIFICATION OF ADVERSE NEONATAL OUTCOMES
Author(s)
Ruchita R. Ranazunjare, PharmD1, Haritha S. Nath, PharmD2, shraddha madhukarrao sawant, PharmD3, Unnati Gupta, PharmD2, Manmay Sunil Bhagwat, PharmD4.
1Student, Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pune, 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, 4Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pimpri Chinchwad, India.
1Student, Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pune, 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, 4Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pune, Pimpri Chinchwad, India.
OBJECTIVES: Early detection of pregnancies with adverse neonatal outcomes is a clinical priority, especially in resource-limited settings. Red cell distribution width (RDW) is routinely included in a complete blood count (CBC), but its potential as an early screening biomarker during pregnancy remains unexplored. Using an inexpensive laboratory parameter, this study assessed the predictive performance and potential clinical value of maternal RDW in determining pregnancies at greater risk of adverse neonatal outcomes.
METHODS: An analytical cross-sectional study was conducted among 257 pregnant women aged 18-40 years at a tertiary care teaching hospital in Pune, India. Regardless of anemia status, women with singleton pregnancies, verified trimester-wise CBC reports, and informed consent were included. Neonatal outcomes including low birth weight (LBW), preterm birth, neonatal intensive care unit (NICU) admissions, and APGAR scores, were compared with maternal RDW across trimesters. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were estimated using trimester-specific receiver operating characteristics-derived RDW cut-offs. JMP software was used for the statistical analysis, and p<0.05 was considered significant.
RESULTS: Over 58% had elevated RDW levels (>14.5%). With sensitivities of 97.56% and 92.98% in the first and third trimesters, respectively, and corresponding NPVs of 95.24% and 90.70%, RDW showed the best predictive performance for preterm birth. PPVs ranging from 72.87% to 79.45% across trimesters, RDW also showed moderate predictive performance for NICU admission. The predictive performance for LBW and APGAR scores was lower, indicating greater utility for screening preterm rather than growth-related outcomes.
CONCLUSIONS: Maternal RDW showed modest value in identifying NICU admissions and clinically significant predictive performance for preterm birth. As RDW is routinely available through standard antenatal CBC testing without additional laboratory costs, it may complement conventional hemoglobin assessment for early pregnancy risk stratification and targeted antenatal surveillance, particularly in resource-limited healthcare settings.
METHODS: An analytical cross-sectional study was conducted among 257 pregnant women aged 18-40 years at a tertiary care teaching hospital in Pune, India. Regardless of anemia status, women with singleton pregnancies, verified trimester-wise CBC reports, and informed consent were included. Neonatal outcomes including low birth weight (LBW), preterm birth, neonatal intensive care unit (NICU) admissions, and APGAR scores, were compared with maternal RDW across trimesters. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were estimated using trimester-specific receiver operating characteristics-derived RDW cut-offs. JMP software was used for the statistical analysis, and p<0.05 was considered significant.
RESULTS: Over 58% had elevated RDW levels (>14.5%). With sensitivities of 97.56% and 92.98% in the first and third trimesters, respectively, and corresponding NPVs of 95.24% and 90.70%, RDW showed the best predictive performance for preterm birth. PPVs ranging from 72.87% to 79.45% across trimesters, RDW also showed moderate predictive performance for NICU admission. The predictive performance for LBW and APGAR scores was lower, indicating greater utility for screening preterm rather than growth-related outcomes.
CONCLUSIONS: Maternal RDW showed modest value in identifying NICU admissions and clinically significant predictive performance for preterm birth. As RDW is routinely available through standard antenatal CBC testing without additional laboratory costs, it may complement conventional hemoglobin assessment for early pregnancy risk stratification and targeted antenatal surveillance, particularly in resource-limited healthcare settings.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO81
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Clinical Outcomes Assessment, Performance-based Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Pediatrics, Reproductive & Sexual Health, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)