Background: Preeclampsia is a pregnancy-specific disorder characterized by multisystem involvement and significant maternal–fetal morbidity. Emerging evidence suggests that hematological indices may reflect underlying pathophysiological mechanisms, including inflammation, oxidative stress, and impaired erythropoiesis.
Methods: This case–control study was conducted on 130 pregnant women (65 cases and 65 controls) referred to Shahid Rahimi Hospital between 2023 and 2024. Participants were matched based on maternal age and gestational age. Demographic characteristics and hematological parameters, including hemoglobin (Hb), hematocrit (HCT), red blood cell (RBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW), were extracted from medical records. Independent t-tests and analysis of covariance (ANCOVA) were used, adjusting for age, body mass index (BMI), education level, and parity.
Results: Significant differences were observed in MCV, MCHC, and RDW between groups. MCV and MCHC were significantly lower in the preeclampsia group, whereas RDW was significantly higher (P < 0.001 for all). These associations remained significant after adjustment for confounders. No significant differences were observed in Hb, HCT, RBC count, or MCH.
Conclusion: Alterations in red blood cell indices, particularly RDW, MCV, and MCHC, are associated with preeclampsia and may reflect underlying pathophysiological processes including inflammation, oxidative stress, and impaired erythropoiesis. These routinely available parameters may have potential value as adjunct biomarkers for clinical assessment and risk stratification in preeclampsia, although further prospective and mechanistic studies are required to confirm their clinical utility.
Mechanistic and Translational Relevance: These hematological indices may reflect underlying processes including inflammation, oxidative stress, and impaired erythropoiesis in preeclampsia. Given their routine availability and low cost, they may serve as accessible biomarkers of systemic involvement and could support adjunctive clinical assessment and risk stratification, particularly in resource-limited settings.