Reference intervals for reticulocyte parameters (reticulocyte haemoglobin equivalent and immature reticulocyte fraction) in first-trimester pregnancy

Abstract

Reticulocyte parameters including reticulocyte haemoglobin equivalent (Ret-He) and immature reticulocyte fraction (IRF) are newly recognised hematological parameters that are being used for diagnosis and follow-up of anaemic patients. Reference intervals of these parameters have been established in different populations, however, the data relating to pregnancy are still lacking. One hundred and fifty-five first-trimester pregnant females were screened and the reference interval was calculated after selecting the patient with fixed criteria. R statistical software was used for statistical calculations. We tried to establish a reference interval of Ret-He content and IRF in first-trimester pregnancy in our study.

IMPACT STATEMENT

• What is already known on this subject? Ret-He and IRF have been established as the marker of iron deficiency and iron-deficiency anaemia in different age groups and as a marker of response to iron therapy. However, literature is scarce regarding the reference intervals of these parameters, especially in pregnancy.

• What do the results of this study add? This study establishes the reference interval of newer reticulocyte parameters in first-trimester pregnancy which is not yet established in the literature. Establishing a reference interval is required for any laboratory parameters to be used in the clinical context.

• What are the implications of these findings for clinical practice and further research? The results of this study may help in making a clinical decision regarding iron deficiency in early pregnancy which is one of the common clinical problems in pregnancy. This study also serves as a baseline study for further studies of reference intervals for newer reticulocyte parameters in pregnancy. A similar study with a larger study population and follow-up with iron therapy may establish these parameters as one of the important markers of iron deficiency in pregnancy and help institute iron therapy on case-to-case basis.

Keywords:

• Intrapartum care
• general obstetrics
• reticulocyte parameters

Ethical approval

The study has been approved by Institutional Ethics Committee Vide Reference No. AIIMS/IEC/18/158.

Acknowledgement

We would like to thank Dr. Jaya Chaturvedi, Professor and Head, Department of OBG for her support in this study.

Author contributions

1. Utpal Kumar – prepared primary manuscript, concept, gathered patient data, performed laboratory work and results.

2. Arvind Kumar Gupta – prepared and corrected manuscript, concept.

3. Neha Singh – prepared and corrected manuscript, concept.

4. Harish Chandra – prepared and corrected manuscript, concept, overall study design and overseeing.

5. Nilotpal Chowdhury – prepared and corrected manuscript, concept, statistical analysis and results.

All the authors also read the final manuscript and corrected it as required.

Disclosure statement

No potential conflict of interest was reported by the author(s).