Predictive Potential of Red Blood Cell Distribution Width and Platelet Ratio (RDW/PLT) in Early Pregnancy Loss

This study aimed to evaluate the diagnostic value of the ratio of red blood cell distribution width (RDW) to platelet count (PLT) in the diagnosis of incomplete abortion in patients presenting to obstetric practice.

This retrospective study includes 289 patients. Of these, 126 were in the incomplete abortion group and 163 were in the elective abortion group, which was terminated without medical indication. Patients who were not between 5 and 12 weeks of gestation, those with signs of infection, those with chronic disease or those taking regular medication, and those without complete blood count data were excluded from the study. Hemoglobin, RDW and PLT values recorded at the time of the initial pregnancy diagnosis were examined. Blood samples were obtained during the initial pregnancy visit before the diagnosis of incomplete abortion and prior to curettage in the elective abortion group. The RDW/PLT ratio was subsequently calculated and included in the statistical analyses. Receiver operating characteristic (ROC) analysis was used to assess the risk of incomplete abortion, and binary logistic regression analysis was used to examine independent predictors. The level of statistical significance was set at p<0.050.

A total of 289 patients were included in the study, comprising 126 patients with incomplete abortion and 163 women undergoing elective abortion. The incomplete abortion and elective abortion groups showed similar baseline characteristics. In binary logistic regression analysis, gestational age, RDW, PLT, and the RDW/PLT ratio were significant predictors of incomplete abortion in the univariate model. In the multivariate model, only maternal age, gestational age, and the RDW/PLT ratio remained independently associated with incomplete abortion. ROC analysis demonstrated no diagnostic value for hemoglobin, while RDW and PLT showed moderate predictive performance. The RDW/PLT ratio exhibited the highest discriminatory ability (AUC = 0.824), with a cut-off value of ≥0.054 yielding 71.4% sensitivity and 79.1% specificity. The overall diagnostic accuracy of the RDW/PLT ratio index was 75.78%.

This study demonstrates that the RDW/PLT ratio is a simple and accessible hematological marker that may represent a complementary hematological marker associated with early pregnancy loss risk. The findings suggest that this index may provide complementary support to clinical decision-making processes.