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Article Open Access

Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women

  • Authors:
    • Danijela Županić
    • Alenka Višnić
    • Tina Brenčić
    • Gordana Juričić
    • Lorena Honović
    • Tea Štimac
  • View Affiliations / Copyright

    Affiliations: Department of Laboratory Diagnostics, General Hospital Pula, 52100 Pula, Croatia, Department for Gynecology and Obstetrics, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia, Medical Biochemistry Laboratory, Istrian Health Center, 52000 Pazin, Croatia
    Copyright: © Županić et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 188
    |
    Published online on: October 3, 2025
       https://doi.org/10.3892/br.2025.2066
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Abstract

Iron deficiency anaemia (IDA) is a common condition during pregnancy. The aim of the present study was to determine the diagnostic accuracy measures and define the optimal parameters for diagnosing IDA. Simple parameters, such as erythrocyte count (E), iron (Fe), haematocrit (HCT), mean corpuscular volume of erythrocytes (MCV), and red blood cell distribution width (RDW), were included and several ratios were calculated (Fe/E, MCV/RDW, RDW/E, RDW/Fe, and RDW/HCT). Additionally, a scoring model was proposed. A total of 623 pregnant women were included in the present study, and the blood was obtained a day before or on the day of delivery. Simple parameters and calculated ratios were determined. The clinical criterion for IDA diagnosis was defined based on the World Health Organization threshold of haemoglobin <110 g/l, and pregnant women were classified as anaemic or non‑anaemic based on this metric. The values of all assessed parameters were significantly different (P<0.001) between the two groups. A weak correlation was identified for MCV, Fe/E, and MCV/RDW; a moderate correlation for E, Fe, RDW/E, and RDW/Fe; and a strong correlation for HCT and RDW/HCT. No correlation was identified for RDW. Markedly high diagnostic accuracy for IDA diagnosis was obtained with an area under the curve (AUC) of 0.921 for the calculated parameter RDW/HCT >43.64 l/lx10‑2, and an AUC of 0.973 for the simple parameter HCT ≤0.32 l/l.  RDW/HCT and HCT demonstrated the highest diagnostic accuracy, and may be useful parameters in routine practice for the diagnosis of IDA.
View Figures

Figure 1

Receiver operating characteristic
curve for E. E, erythrocyte count; AUC, area under the curve.

Figure 2

Receiver operating characteristic
curve for Fe. Fe, iron; AUC, area under the curve.

Figure 3

Receiver operating characteristic
curve for HCT. HCT, haematocrit; AUC, area under the curve.

Figure 4

Receiver operating characteristic
curve for MCV. MCV, mean corpuscular volume; AUC, area under the
curve.

Figure 5

Receiver operating characteristic
curve for RDW. RDW, red blood cell distribution width; AUC, area
under the curve.

Figure 6

Receiver operating characteristic
curve for Fe/E. Fe/E, iron/erythrocyte ratio; AUC, area under the
curve.

Figure 7

Receiver operating characteristic
curve for MCV/RDW. MCV/RDW, mean corpuscular volume/red blood cell
distribution width ratio; AUC, area under the curve.

Figure 8

Receiver operating characteristic
curve for RDW/E. RDW/E, red blood cell distribution
width/erythrocyte ratio; AUC, area under the curve.

Figure 9

Receiver operating characteristic
curve for RDW/Fe. RDW/Fe, red blood cell distribution width/iron
ratio; AUC, area under the curve.

Figure 10

Receiver operating characteristic
curve for RDW/HCT. RDW/HCT, red blood cell distribution
width/haematocrit ratio; AUC, area under the curve.

Figure 11

Comparison of the receiver operating
characteristic curves for all calculated parameters. Fe/E,
iron/erythrocyte ratio; MCV/RDW, mean corpuscular volume/red blood
cell distribution width ratio; RDW/E, red blood cell distribution
width/erythrocyte ratio; RDW/Fe, red blood cell distribution
width/iron ratio; RDW/HCT, red blood cell distribution
width/haematocrit ratio.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Županić D, Višnić A, Brenčić T, Juričić G, Honović L and Štimac T: Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women. Biomed Rep 23: 188, 2025.
APA
Županić, D., Višnić, A., Brenčić, T., Juričić, G., Honović, L., & Štimac, T. (2025). Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women. Biomedical Reports, 23, 188. https://doi.org/10.3892/br.2025.2066
MLA
Županić, D., Višnić, A., Brenčić, T., Juričić, G., Honović, L., Štimac, T."Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women". Biomedical Reports 23.6 (2025): 188.
Chicago
Županić, D., Višnić, A., Brenčić, T., Juričić, G., Honović, L., Štimac, T."Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women". Biomedical Reports 23, no. 6 (2025): 188. https://doi.org/10.3892/br.2025.2066
Copy and paste a formatted citation
x
Spandidos Publications style
Županić D, Višnić A, Brenčić T, Juričić G, Honović L and Štimac T: Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women. Biomed Rep 23: 188, 2025.
APA
Županić, D., Višnić, A., Brenčić, T., Juričić, G., Honović, L., & Štimac, T. (2025). Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women. Biomedical Reports, 23, 188. https://doi.org/10.3892/br.2025.2066
MLA
Županić, D., Višnić, A., Brenčić, T., Juričić, G., Honović, L., Štimac, T."Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women". Biomedical Reports 23.6 (2025): 188.
Chicago
Županić, D., Višnić, A., Brenčić, T., Juričić, G., Honović, L., Štimac, T."Clinical utility of calculated haematological parameters in the diagnosis of iron deficiency anaemia in pregnant women". Biomedical Reports 23, no. 6 (2025): 188. https://doi.org/10.3892/br.2025.2066
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