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 for statistical analysis, adjusting for age, body mass index (BMI), education level, and parity.
Results: Significant differences were observed in MCV, MCHC, and RDW between the two groups. MCV and MCHC were significantly lower in the preeclampsia group, while RDW was significantly higher (P = 0.001 for all). These associations remained statistically significant after adjustment for confounding variables. No significant differences were observed in Hb, HCT, RBC count, or MCH.
Conclusion: Alterations in RBC indices, particularly RDW, MCV, and MCHC, are associated with preeclampsia and may reflect underlying biological processes such as oxidative stress, inflammation, and impaired erythropoiesis. These routinely available hematological parameters may have potential translational value as accessible biomarkers for clinical assessment and risk stratification in preeclampsia, although further mechanistic and prospective studies are warranted.
Mechanistic and Translational Relevance: These hematological indices may reflect underlying inflammation, oxidative stress, and impaired erythropoiesis in preeclampsia. They may serve as accessible, low-cost biomarkers of systemic involvement and could support adjunctive clinical assessment and risk stratification, particularly in resource-limited settings.