Red Cell Distribution Width as a Predictor of Persistent Pulmonary Hypertension of the Newborn

Abstract

Objective Persistent pulmonary hypertension of the newborn (PPHN) is a critical condition with high mortality and morbidity rates in neonatal intensive care unit (NICU) admitted neonates due to severe hypoxemia. The aim of this study was to evaluate red cell distribution width (RDW) as a biomarker of hypoxemia and determine the optimal cutoff point of RDW for identifying neonates with PPHN. Study Design All PPHN diagnosed, NICU admitted term infants with hypoxemia after birth from May 2014 to September 2016 were enrolled as case control and healthy term infants with nonhemolytic jaundice who were admitted for phototherapy on the second or third day of birth were the control group. Blood samples were collected. Multiple logistic regression modeling was used to examine the association between PPHN and RDW. Results Receiver-operating characteristics (ROC) curve analysis was used to determine the optimal cutoff point of RDW for identifying neonates with PPHN. RDW was higher in the PPHN group compared with the control group (p < 0.001). Significant predictors of PPHN were mother's underlying disease (p = 0.01) and RDW (p < 0.001). The optimal RDW cut point for prediction of PPHN by the ROC curve analysis was 17.9 (sensitivity = 85.71%). RDW's area under the curve was 0.9197 (p < 0.001). Conclusion RDW may be a simple, valuable, accessible marker for predicting PPHN before performing echocardiography in hypoxemic NICU admitted neonates.

Red cell distribution width and homocysteine act as independent risk factors for cardiovascular events in newly diagnostic essential hypertension

“…Recently, similar with Hcy, RDW was found to be associated with morbidity and mortality in cardiovascular diseases [ 37 ]. A study showed that RDW may be a predictor marker of persistent pulmonary hypertension of the newborn [ 38 ]. In addition, Triantafyllidi et al demonstrated higher RDW values in non-dippers hypertension compared to dippers and normotensives [ 39 ].…”

Impact of gestational week on red cell distribution width in newborns

“…In addition, RDW has been mainly used in the differential diagnosis of anemia but has been recently demonstrated to have a role in adult patients as a prognostic marker in different pathologies, mainly for cardiovascular diseases [11,12]. In recent years, studies evaluating the relationship between RDW and morbidities and mortality in newbrons have been performed [13][14][15][16]. A recent study has shown that patients with persistent pulmonary hypertension (PPHT) had a significant increase in RDW and that RDW could be an independent predictor of PPHT [14].…”

The role of red cell distribution width as a predictor of bronchopulmonary dysplasia in preterm infants

“…As a mechanism of the increase in RDW value, it has been indicated that inflammatory cytokines inhibit erythrocyte maturation and induce the release of younger and larger reticulocytes into the circulation and thus alter the distribution of erythrocytes [7,10,18] . In recent years after trials realized in adult patients and older children, studies evaluating the relationship between RDW and morbidities and mortality in newborns have been performed [6,11,12,19,20] . A recent study has shown that patients with persistent pulmonary hypertension (PPHT) had a significant increase in RDW and that RDW could be an independent predictor of PPHT [20] .…”

“…In recent years after trials realized in adult patients and older children, studies evaluating the relationship between RDW and morbidities and mortality in newborns have been performed [6,11,12,19,20] . A recent study has shown that patients with persistent pulmonary hypertension (PPHT) had a significant increase in RDW and that RDW could be an independent predictor of PPHT [20] .…”