Relationship between Red Cell Distribution Width and Severity of Pre-eclampsia among Pregnant Women in Nigeria

Background: Pre-eclampsia contributes to maternal and perinatal morbidity and mortality, particularly in low-resource settings. Red cell distribution width (RDW), a routinely measured haematological parameter that reflects variations in red blood cell size, may reflect inflammation and disease severity. Aim: This study investigated the relationship between RDW and the severity of pre-eclampsia among pregnant women in Nigeria. Methods: A hospital-based analytical cross-sectional study was conducted at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Ninety-four women with pre-eclampsia were recruited consecutively (47 with and 47 without severe features). Sociodemographic, obstetric, clinical and haematological data were collected. RDW and other blood parameters were measured using an automated haematology analyser. Data were analysed using descriptive statistics, independent-samples t-tests, chi-square tests and correlation analyses, with statistical significance established at p < 0.05. Results: Mean RDW was significantly higher among women with severe features (15.80 ± 2.30%) than those without severe features (13.60 ± 1.80%; p < 0.001). Elevated RDW (≥15%) was observed in 61.70% of women with severe features compared with 25.53% of those without severe features (p < 0.001). Women with severe features also had significantly lower haemoglobin concentrations (10.30 ± 1.40 versus 11.10 ± 1.20 g/dL; p = 0.004) and platelet counts (157.20 ± 62.10 versus 218.40 ± 53.60 × 109/L; p < 0.001). Conclusion: Higher RDW was significantly associated with severe features of pre-eclampsia. RDW may provide an inexpensive adjunct to clinical severity assessment. Further studies are needed to establish its independent predictive value.