Red Cell Indices in Screening of Thalassemia Trait During Antenatal Period

Baliyan et al. (in J Obstet Gynecol https://doi.org/10.1007/s13224-019-01220-8, 2019) in their study evaluated the sensitivity and specificity of MCV and MCH for the screening of the beta thalassemia trait in late pregnancy. However, they failed to rule out iron deficiency, which is a confounding factor for low MCV and MCH; as a result, they observed low specificity. Authors recommend ruling out iron deficiency prior to screening for beta thalassemia and preferably in the first trimester of pregnancy so that antenatal diagnosis can be performed in high-risk subjects if necessary.