Objective. Pre-eclampsia (PE) is a peculiar pregnancy complication with adverse feto-maternal outcomes. Red blood cell distribution width (RDW) and platelet indices are complete blood count parameters; tested as a marker for cardiovascular diseases. The inflammatory theory was proposed for PE etiology; therefore, we aimed to investigate the role of RDW and platelet parameters in determining preeclampsia severity.Patients and methods. At Al-Yarmouk Hospital, we conducted a case-control study. 120 pregnant women satisfied inclusion criteria, divided into two groups. According to American guidelines, PE cases (60/120) and healthy controls (60/120).PE cases were subdivided into severe PE (34/60) and non-severe PE (26/60) cases. A blood sample was aspirated for complete blood count, including RDW, mean platelet volume (MPV), and platelet distribution width (PDW).Results. RDW and MPV were meaningfully higher in PE cases than controls, with a P-value of 0.003 and 0.004, respectively. A significant difference was found in the RDW and PDW in subgroups analysis of severe vs. non-severe PE cases, with Pvalues of 0.001 and 0.037, respectively. Only RDW was significantly correlated with systolic BP; r = 0.47. and diastolic BP; r = 0.399. At a cutoff value of > 15.6%, RDW showed 56.7 %sensitivity and 95.8 % specificity, P < 0.001, distinguishing severe from non-severe PE pregnancies.Conclusions. RDW discriminated PE severity with good accuracy and preceded platelets indices, implying its validity as a marker of severe PE. RDW is a simple, inexpensive test available in antenatal care services. Accurate diagnosis permits early focused treatment, vigorous monitoring, and timely interventions for improving pregnancy outcomes.
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