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<p>β-Thalassemia trait (BTT) is typically screened using various discriminant indices, with confirmation by Hb HPLC. Despite this, many BTT cases remain undetected during routine CBC screening and therefore never undergo Hb HPLC testing. This underscores the need for accessible parameters that can aid BTT detection at the initial antenatal visit. The aim of this study was to evaluate the utility of reticulocyte parameters in screening BTT in antenatal patients. The objectives were to determine the sensitivity of reticulocyte indices generated by automated haematology analysers in detecting BTT and to compare the sensitivity and specificity of these reticulocyte indices with conventional RBC indices in BTT and non-BTT antenatal women. A total of 1000 antenatal patients in the first trimester were screened for BTT using routine CBC, reticulocyte indices and Hb HPLC. All parameters of BTT-positive patients were compared with BTT-negative antenatal controls. Reticulocyte Haemoglobin Equivalent (RHE) &lt; 21.9 pg showed 90.8% sensitivity and 86.7% specificity. Mentzer’s Index &lt; 13.0 demonstrated 98.2% sensitivity and 50.0% specificity, while the ROC-derived cut-off &lt; 15.02 improved specificity to 83.3%. Shine &amp; Lal index sensitivity increased from 85.4% to 93.8% when using a cut-off of 1176.4 instead of 1530, with specificity unchanged at 86.7%. The RHE/MCHC ratio (&lt; 0.68) demonstrated the highest diagnostic efficacy, with 93.6% sensitivity and 73.3% specificity. Reticulocyte parameters, particularly RHE and the RHE/MCHC ratio, serve as useful adjunctive screening tools in antenatal women and may aid in selecting candidates for confirmatory Hb HPLC testing rather than acting as standalone diagnostic tests.</p>

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Role of Reticulocyte Parameters as Adjunct in Antenatal Screening for β-Thalassemia Trait

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Komal Kela,
  • Mrinalini Kotru,
  • Sandhya Jain,
  • Richa Gupta,
  • Manju Jain,
  • Poonam Rani,
  • Technical Assistant

摘要

β-Thalassemia trait (BTT) is typically screened using various discriminant indices, with confirmation by Hb HPLC. Despite this, many BTT cases remain undetected during routine CBC screening and therefore never undergo Hb HPLC testing. This underscores the need for accessible parameters that can aid BTT detection at the initial antenatal visit. The aim of this study was to evaluate the utility of reticulocyte parameters in screening BTT in antenatal patients. The objectives were to determine the sensitivity of reticulocyte indices generated by automated haematology analysers in detecting BTT and to compare the sensitivity and specificity of these reticulocyte indices with conventional RBC indices in BTT and non-BTT antenatal women. A total of 1000 antenatal patients in the first trimester were screened for BTT using routine CBC, reticulocyte indices and Hb HPLC. All parameters of BTT-positive patients were compared with BTT-negative antenatal controls. Reticulocyte Haemoglobin Equivalent (RHE) < 21.9 pg showed 90.8% sensitivity and 86.7% specificity. Mentzer’s Index < 13.0 demonstrated 98.2% sensitivity and 50.0% specificity, while the ROC-derived cut-off < 15.02 improved specificity to 83.3%. Shine & Lal index sensitivity increased from 85.4% to 93.8% when using a cut-off of 1176.4 instead of 1530, with specificity unchanged at 86.7%. The RHE/MCHC ratio (< 0.68) demonstrated the highest diagnostic efficacy, with 93.6% sensitivity and 73.3% specificity. Reticulocyte parameters, particularly RHE and the RHE/MCHC ratio, serve as useful adjunctive screening tools in antenatal women and may aid in selecting candidates for confirmatory Hb HPLC testing rather than acting as standalone diagnostic tests.