Red blood cell parameters in antenatal nonsickling hemoglobinopathy screening.
OBJECTIVE
To find a hematological parameter and the cut-off level for identification of nonsickling hemoglobinopathies in pregnant women.


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.


CONCLUSIONS
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%.
Department of Obstetrics and Gynecology, Institute of Obstetric Research, University Hospital Zurich, Zurich, Switzerland.
Gabriela
G
Bencaiova
Department of Obstetrics and Gynecology, Institute of Obstetric Research, University Hospital Zurich, Zurich, Switzerland.
Kristina
K
Dapoto
Department of Obstetrics and Gynecology, Institute of Obstetric Research, University Hospital Zurich, Zurich, Switzerland.
Roland
R
Zimmermann
Department of Obstetrics and Gynecology, Institute of Obstetric Research, University Hospital Zurich, Zurich, Switzerland.
Alexander
A
Krafft
anemia; antenatal; hematological parameters; hemoglobin; hemoglobinopathy; pregnancy; screening