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Red blood cell parameters in antenatal nonsickling hemoglobinopathy screening

Authors Bencaiova G, Dapoto K, Zimmermann R, Krafft A

Received 28 August 2014

Accepted for publication 17 November 2014

Published 8 April 2015 Volume 2015:7 Pages 379—384


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Editor who approved publication: Professor Elie Al-Chaer

Gabriela Bencaiova, Kristina Dapoto, Roland Zimmermann, Alexander Krafft

Department of Obstetrics and Gynecology, Institute of Obstetric Research, University Hospital Zurich, Zurich, Switzerland

Objective: To find a hematological parameter and the cut-off level for identification of nonsickling hemoglobinopathies in pregnant women.
Materials and methods: Venous blood samples of 849 women with singleton pregnancies were collected at the first visit. All women who met inclusion criteria were examined for nonsickling hemoglobinopathy. On the basis of the sensitivity and the specificity of different cut-off levels for hematological parameters, we calculated the optimal clinically practicable parameter for screening of nonsickling hemoglobinopathies in pregnant women.
Results: On the basis of the sensitivity and the specificity, the best screening parameters for the identification of nonsickling hemoglobinopathies among nonanemic pregnant women are mean corpuscular volume (MCV) with cut-off ≤80 fL (Youden’s index 91.2%), mean corpuscular hemoglobin (MCH) <27.5 pg (Youden’s index 90.7%), and microcytosis (MRC) ≥3% (Youden’s index 90.2%). An analysis using receiver operating characteristic curves and the calculated Youden’s index showed that MCV ≤76 fL, MCH ≤24 pg, or MRC ≥10% are the best red blood cell indices for the screening of nonsickling hemoglobinopathy among anemic women with iron deficiency.
Conclusion: Our results suggest targeted screening for nonsickling hemoglobinopathies in nonanemic pregnant women with MCV ≤80 fL, MCH ≤27.5 pg, or MRC ≥3% and in anemic women with MCV ≤76 fL, MCH ≤24 pg, or MRC ≥10%.

Keywords: anemia, antenatal, hemoglobinopathy, pregnancy, screening, hemoglobin, hematological parameters

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