Adam Ishag, Mutabingwa Theonest K, Malik Elfatih M
1Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
2Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.
Clin Hypertens. 2019 Jul 15;25:15. doi: 10.1186/s40885-019-0119-7. eCollection 2019.
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.
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.
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) %, < 0.001]. The mean difference was 0.85, 95% CI = 0.26-1.43. Due to a high heterogeneity (I = 90.45, < 0.001), the continuous random effect model was used.Eight studies compared RDW level in the mild ( = 360) with severe cases ( = 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) %, < 0.001]. The mean difference was 1.07, 95% CI = 0.45-1.70. Since there is a high heterogeneity [I = 76.67, < 0.001], the continuous random effect model was used.Through the met-regression model, except for the region of the study ( < 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, < 0.001. Because of heterogeneity [I = 69.6, = 0.002], the continuous random effect model was used.
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.
子痫前期是一种严重的妊娠相关疾病，可能对母亲和胎儿的健康产生不良影响。尽管有许多关于红细胞分布宽度（RDW）与子痫前期关联的出版物，但尚未有发表的荟萃分析。因此，有必要进行本次系统评价和荟萃分析，以评估RDW与子痫前期的关系。
遵循系统评价和荟萃分析的首选报告项目指南。在PubMed、Cochrane图书馆、谷歌学术、Scopus、Embase和CINAHL中使用“子痫前期或子痫与红细胞分布宽度或红细胞”一词搜索相关已发表研究。使用改良的纽卡斯尔-渥太华质量评估量表对检索到的研究进行批判性评价。使用OpenMeta Analyst软件计算合并的Meta逻辑回归。采用亚组分析和Meta回归方法分析异质性。
荟萃分析纳入了11项病例对照研究，共951例病例（子痫前期）和2024例对照。子痫前期女性的RDW水平均值（标准差）显著高于对照组[15.10（2.48）%对14.26（1.71）%，P<0.001]。平均差异为0.85，95%置信区间为0.26 - 1.43。由于异质性较高（I² = 90.45，P<0.001），采用连续随机效应模型。八项研究比较了轻度子痫前期（n = 360）和重度子痫前期（n = 354）患者的RDW水平。重度子痫前期女性的RDW水平显著高于轻度子痫前期女性[15.37（2.48）%对14.037（1.79）%，P<0.001]。平均差异为1.07，95%置信区间为0.45 - 1.70。由于异质性较高[I² = 76.67，P<0.001]，采用连续随机效应模型。通过Meta回归模型，除研究地区外（P<0.001），所调查的变量（年龄、产次、研究质量）均与所调查的异质性无显著关联。剔除异常值（3项研究）以降低异质性。其余8项研究的合并荟萃分析显示，子痫前期女性与对照组之间的RDW存在显著差异。平均差异为0.93，95%置信区间为0.56 - 1.31，P<0.001。由于存在异质性[I² = 69.6，P = 0.002]，采用连续随机效应模型。
子痫前期女性的RDW水平显著高于对照组。同样，重度子痫前期女性的RDW显著高于轻度子痫前期女性。
