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Red blood cell distribution width and iron deficiency anemia among pregnant Sudanese women

Esam G Abdelrahman1, Gasim I Gasim13, Imad R Musa14, Leana M Elbashir24 and Ishag Adam24*

Author affiliations

1 Khartoum Teaching Hospital, Khartoum, Sudan

2 Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan

3 Faculty of Medicine, Qassim, University, Qassim, Qassim, Kingdom of Saudi Arabia

4 Buraidah Central Hospital, Buraidah, Kingdom of Saudi Arabia

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Citation and License

Diagnostic Pathology 2012, 7:168  doi:10.1186/1746-1596-7-168

Published: 3 December 2012



Iron deficiency anemia (IDA) is a major health problem during pregnancy and it has adverse effects on the mother and the newborn. Red cell distribution width (RDW), which is a quantitative measure for red cell size variation (anisocytosis), is a predictor of IDA. Little is known regarding RDW and IDA during pregnancy.


A cross sectional study was conducted at the antenatal clinic of Khartoum Hospital, Sudan, to determine the performance of RDW in the diagnosis of IDA using serum ferritin as a gold standard.


Among 194 pregnant women with a gestational period of 21.4 ± 6.5 weeks, 57 (29.4%) had IDA according to serum ferritin levels (<15 μg/l) and 61 (31.4%) had IDA according to RDW (>14.5). The sensitivity, specificity, positive predictive value, and negative predictive value of RDW where serum ferritin was the gold standard were 43.8% (95% CI: 31.4–57.0%), 73.7% (95% CI: 65.8–80.5%), 41.0% (95% CI: 29.2–53.6%), and 76.0% (95% CI: 68.1–82.6%), respectively.


In this study, we found that RDW has a poor performance in diagnosing IDA among pregnant women compared with serum ferritin as the gold standard.

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Anemia; Pregnancy; Red cell distribution width; Sudan