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Can RBC Indices be Used as Screening Test for Beta-Thalassemia in Indian Antenatal Women?

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Abstract

Objective

To determine the appropriateness of using MCV/MCH as screening test for beta-thalassemia trait in the present population and also to find the most appropriate cutoff for optimum sensitivity of these indices.

Methods

It was an analytical, observational and cross-sectional study. Complete blood count followed by high-performance liquid chromatography (HPLC) was performed. The MCV and MCH levels were noted in cases and controls.

Results

Thalassemia trait was found in 66 out of 1300 antenatal women with anemia. The MCV and MCH were significantly low in cases (p = 0.0001). MCV had a better AUC (0.650) than MCH (0.635). The most suitable cutoff value of MCV was calculated as 72 fl (sensitivity—63.7%, specificity—68.3%, PPV—9.7%, LR—2.0) and that for MCH was 24 pg (sensitivity—63.6%, specificity—59.4%, PPV—7.7%, LR—1.5) using Youden’s index. When MCH (cutoff of 28 pg) and MCV were combined (cutoff of 74 fl), the sensitivity and specificity were 95% and 16%, respectively.

Conclusion

The sensitivity and specificity of MCV and MCH alone had low detection rate when used in combination had high sensitivity but the specificity was low; therefore, HPLC should be the preferred screening test for beta-thalassemia in Indian women.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, 110001, India

    Mayura Baliyan & Manisha Kumar

  2. Department of Pathology, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, 110001, India

    Anita Nangia

  3. KSCH, New Delhi, India

    Nupur Parakh

Authors
  1. Mayura Baliyan
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  2. Manisha Kumar
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  3. Anita Nangia
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  4. Nupur Parakh
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Contributions

Mayura Balliyan conducted the study, co-analyzed the data, and drafted and revised the manuscript. Manisha Kumar was involved in the concept and planning of the study, conducted the study, co-analyzed the data and drafted the manuscript. Anita Nangia conducted the study and drafted the manuscript. Nupur Parakh conducted the study and revised the manuscript.

Corresponding author

Correspondence to Manisha Kumar.

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There is no potential conflict of interest among authors.

Human Participants and Informed Consent

The research involved human participants. Informed consent was taken before the study.

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Ethical clearance was taken before the study.

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Mayura Baliyan is a Resident at Department of Obstetrics and Gynecology, LHMC, New Delhi, India. Manisha Kumar is a Professor (OBGYN) at Department of Obstetrics and Gynecology, LHMC, New Delhi, India. Anita Nangia is a Professor at Department of Pathology, LHMC, New Delhi, India. Nupur Parakh is a Senior Medical Officer at KSCH, New Delhi, India.

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Cite this article

Baliyan, M., Kumar, M., Nangia, A. et al. Can RBC Indices be Used as Screening Test for Beta-Thalassemia in Indian Antenatal Women?. J Obstet Gynecol India 69, 495–500 (2019). https://doi.org/10.1007/s13224-019-01220-8

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  • DOI: https://doi.org/10.1007/s13224-019-01220-8

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