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Red cell distribution width and preeclampsia: a systematic review and meta-analysis
BACKGROUND: Preeclampsia is a serious pregnancy-related disease which may lead to adverse health effects to the mother and fetus. Besides many publications on the association of red cell distribution width (RDW) and preeclampsia, there has been no published meta-analysis. This necessitated the prese...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628484/ https://www.ncbi.nlm.nih.gov/pubmed/31338207 http://dx.doi.org/10.1186/s40885-019-0119-7 |
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author | Adam, Ishag Mutabingwa, Theonest K. Malik, Elfatih M. |
author_facet | Adam, Ishag Mutabingwa, Theonest K. Malik, Elfatih M. |
author_sort | Adam, Ishag |
collection | PubMed |
description | BACKGROUND: Preeclampsia is a serious pregnancy-related disease which may lead to adverse health effects to the mother and fetus. Besides many publications on the association of red cell distribution width (RDW) and preeclampsia, there has been no published meta-analysis. This necessitated the present systemic review and met-analysis to assess the RDW in relation to preeclampsia. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Relevant published studies were searched in PubMed, Cochrane library, Google scholar, Scopus, Embase and CINAHL using the term “Preeclampsia OR eclampsia AND red cell distribution width OR red blood cells). Modified Newcastle – Ottawa quality assessment scale was used for critical appraisal of retrieved studies. Pooled Meta logistic regression was computed using OpenMeta Analyst software. Subgroup and meta-regression methods were performed to analyse the heterogeneity. RESULTS: Eleven case control studies were included in the met-analyses with a total of 951 cases (preeclampsia) and 2024 controls. The mean (SD) of the RDW level was significantly higher in women with preeclampsia compared to controls [15.10 (2.48) % vs. 14.26(1.71) %, P < 0.001]. The mean difference was 0.85, 95% CI = 0.26–1.43. Due to a high heterogeneity (I(2) = 90.45, P < 0.001), the continuous random effect model was used. Eight studies compared RDW level in the mild (N = 360) with severe cases (N = 354) of preeclampsia. The RDW level was significantly higher in women with severe preeclampsia compared to those with mild preeclampsia [15.37 (2.48) % vs. 14.037(1.79) %, P < 0.001]. The mean difference was 1.07, 95% CI = 0.45–1.70. Since there is a high heterogeneity [I(2) = 76.67, P < 0.001], the continuous random effect model was used. Through the met-regression model, except for the region of the study (P < 0.001), none of investigated variables (age, parity, quality of the study) was significantly associated with the investigated heterogeneity. The outliers (3studies) were removed to reduce the heterogeneity. The pooled meta-analysis of the remaining 8 studies showed a significant difference in the RDW between preeclamptic women compared with the controls. The mean difference was 0.93, 95% CI = 0.56–1.31, P < 0.001. Because of heterogeneity [I(2) = 69.6, P = 0.002], the continuous random effect model was used. CONCLUSION: RDW level was significantly higher in women with preeclampsia compared to controls. Similarly, women with severe preeclampsia had significantly higher RDW than those with the mild form. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40885-019-0119-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6628484 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66284842019-07-23 Red cell distribution width and preeclampsia: a systematic review and meta-analysis Adam, Ishag Mutabingwa, Theonest K. Malik, Elfatih M. Clin Hypertens Research BACKGROUND: Preeclampsia is a serious pregnancy-related disease which may lead to adverse health effects to the mother and fetus. Besides many publications on the association of red cell distribution width (RDW) and preeclampsia, there has been no published meta-analysis. This necessitated the present systemic review and met-analysis to assess the RDW in relation to preeclampsia. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Relevant published studies were searched in PubMed, Cochrane library, Google scholar, Scopus, Embase and CINAHL using the term “Preeclampsia OR eclampsia AND red cell distribution width OR red blood cells). Modified Newcastle – Ottawa quality assessment scale was used for critical appraisal of retrieved studies. Pooled Meta logistic regression was computed using OpenMeta Analyst software. Subgroup and meta-regression methods were performed to analyse the heterogeneity. RESULTS: Eleven case control studies were included in the met-analyses with a total of 951 cases (preeclampsia) and 2024 controls. The mean (SD) of the RDW level was significantly higher in women with preeclampsia compared to controls [15.10 (2.48) % vs. 14.26(1.71) %, P < 0.001]. The mean difference was 0.85, 95% CI = 0.26–1.43. Due to a high heterogeneity (I(2) = 90.45, P < 0.001), the continuous random effect model was used. Eight studies compared RDW level in the mild (N = 360) with severe cases (N = 354) of preeclampsia. The RDW level was significantly higher in women with severe preeclampsia compared to those with mild preeclampsia [15.37 (2.48) % vs. 14.037(1.79) %, P < 0.001]. The mean difference was 1.07, 95% CI = 0.45–1.70. Since there is a high heterogeneity [I(2) = 76.67, P < 0.001], the continuous random effect model was used. Through the met-regression model, except for the region of the study (P < 0.001), none of investigated variables (age, parity, quality of the study) was significantly associated with the investigated heterogeneity. The outliers (3studies) were removed to reduce the heterogeneity. The pooled meta-analysis of the remaining 8 studies showed a significant difference in the RDW between preeclamptic women compared with the controls. The mean difference was 0.93, 95% CI = 0.56–1.31, P < 0.001. Because of heterogeneity [I(2) = 69.6, P = 0.002], the continuous random effect model was used. CONCLUSION: RDW level was significantly higher in women with preeclampsia compared to controls. Similarly, women with severe preeclampsia had significantly higher RDW than those with the mild form. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40885-019-0119-7) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-15 /pmc/articles/PMC6628484/ /pubmed/31338207 http://dx.doi.org/10.1186/s40885-019-0119-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Adam, Ishag Mutabingwa, Theonest K. Malik, Elfatih M. Red cell distribution width and preeclampsia: a systematic review and meta-analysis |
title | Red cell distribution width and preeclampsia: a systematic review and meta-analysis |
title_full | Red cell distribution width and preeclampsia: a systematic review and meta-analysis |
title_fullStr | Red cell distribution width and preeclampsia: a systematic review and meta-analysis |
title_full_unstemmed | Red cell distribution width and preeclampsia: a systematic review and meta-analysis |
title_short | Red cell distribution width and preeclampsia: a systematic review and meta-analysis |
title_sort | red cell distribution width and preeclampsia: a systematic review and meta-analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628484/ https://www.ncbi.nlm.nih.gov/pubmed/31338207 http://dx.doi.org/10.1186/s40885-019-0119-7 |
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