During pregnancy, your blood volume increases by up to 50%. With a decline in hemoglobin levels and hematocrit (particularly in the last trimester), the platelet count also slightly decreases. However, the white blood cells (WBCs) in the blood increase following pregnancy, termed leukocytosis. Leukocytes or WBCs are classified as agranulocytes (lymphocytes and monocytes) and granulocytes (eosinophils, neutrophils, and basophils), which make up the body’s immune system and fight against infection (1). Read this post to know about the causes of high WBC count in pregnancy and the complications associated with this condition.
What Is The White Blood Cell Count During Pregnancy?
Following pregnancy, there is a gradual increase in the normal WBC count (leukocytosis), with a slight shift toward an increased percentage of neutrophils. Leukocytosis begins in the first trimester, continues throughout the pregnancy, peaks during delivery, and usually normalizes after four weeks (1) (2). However, several studies have associated leukocytosis in the first trimester with a complicated pregnancy, preeclampsia, and gestational diabetes mellitus (GDM) (3) (4). Therefore, the leukocyte count must be correctly interpreted and correlated during your antenatal visits and postnatal care (1).
What Are The Causes of High WBC Count During Pregnancy?
Liesel Teen, BSN, a registered labor and delivery nurse from Raleigh, North Carolina, says, “Even in healthy pregnancies, it is normal for a woman’s WBC count to increase, especially towards the end of pregnancy. However, if this elevation is accompanied by any signs of infection or other medical conditions, it likely will warrant further testing and evaluation. “Specific causes of elevated WBC counts include bacterial or viral infections, leukemia, rheumatoid arthritis, tuberculosis, certain medications (such as epinephrine or corticosteroids), severe allergic reactions, and even severe stress. Any bacterial or viral infection in the body can result in an elevation in a person’s white blood cell count.” In general, an increased WBC count indicates (1)
Acute infection Trauma Dehydration Image: iStock Hemoconcentration Cancer (such as chronic leukemia) Overuse of medications such as corticosteroids
However, due to the physiological stress caused by pregnancy, you may have a higher WBC count even in normal pregnancy. Hence, maternal WBC count cannot be a primary screening technique for detecting severe pregnancy complications (5). Conversely, an increased WBC count in your urine sample indicates a urinary tract infection (UTI) (6). Pregnancy demands a complex physiological response where the endocrine system, metabolic processes, and genital system undergo several changes to nourish the developing fetus and prepare the body for labor and delivery. As your pregnancy progresses, this physiological and emotional stress raises your leukocyte count as the leukocytes accept stimulatory impulses (7).
What Does The White Blood Cell Differential Count Indicate In Pregnancy?
During a healthy pregnancy, leukocytosis is generally referred to as an increased percentage of neutrophils in the blood. However, there are many types of WBCs, and elevated levels of other WBCs may imply different diagnoses (1) (8).
How To Diagnose High White Blood Cell Count During Pregnancy?
In general, the leukocyte count is measured as part of a complete blood count (CBC) test, a routine test during pregnancy. Your doctor may test your blood for hemoglobin, WBC, and platelet counts in almost every prenatal visit to look for conditions that may complicate the pregnancy (6).
What Are The Signs Of High White Blood Cell Count During Pregnancy?
A high WBC count may not present any symptoms in pregnancy. However, the symptoms of a high WBC count in non-pregnant people usually include (9)
Fever Bruising/bleeding tendency Fatigue Immunosuppression Night sweats Weight loss
If you detect any of these symptoms while pregnant, contact your healthcare provider, as it may be a sign of infection or underlying medical complications.
Can A High White Blood Cell Count Cause Miscarriage?
While leukocytosis is common during pregnancy, it could also result from an underlying problem that typical prenatal WBC count tests cannot detect, necessitating extra screening. In the first trimester, higher platelet levels and WBC counts are linked to a higher risk of miscarriage (5) (10).
