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Isolation of Leukocytes from the Human Maternal-fetal Interface
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Comprehensive reference intervals for white blood cell counts during pregnancy.

Jinxiu Zhu1,2, Zexin Li1,2, Yuguo Deng3,1

  • 1Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, China.

BMC Pregnancy and Childbirth
|January 5, 2024
PubMed
Summary

Pregnancy involves rising white blood cell (WBC) counts. This study established new reference intervals for WBCs during gestation, crucial for identifying infection and pregnancy complication risks.

Keywords:
LeukocytePregnancyPregnancy-related complicationsReference intervalWhite blood cell

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Clinical Pathology

Background:

  • White blood cell (WBC) count naturally increases during pregnancy.
  • Accurate reference intervals are vital for diagnosing infections and complications in pregnant individuals.
  • Existing reference ranges may not adequately reflect physiological changes during gestation.

Purpose of the Study:

  • To establish comprehensive, pregnancy-specific reference intervals for white blood cell (WBC) counts.
  • To correlate WBC count variations with gestational stages and identify potential clinical implications.
  • To provide updated guidelines for monitoring maternal health during pregnancy.

Main Methods:

  • Analysis of weekly WBC counts from 17,737 pregnant women, spanning pre-pregnancy to postpartum.
  • Utilized threshold linear regression modeling to determine reference intervals.
  • Employed Harris and Boyd's test for partitioning and validating the established intervals.

Main Results:

  • A significant, progressive increase in WBC count was observed throughout pregnancy, particularly in neutrophils.
  • Partitioned reference intervals were established: < = 2 weeks (4.0-10.0 × 10^9/L), 3-5 weeks (4.7-11.9 × 10^9/L), and >= 6 weeks (5.7-14.4 × 10^9/L).
  • Elevated WBC counts within these intervals correlated with increased incidence of complications like placenta previa and intrauterine growth restriction.

Conclusions:

  • This study successfully established new, gestational-age-specific reference intervals for WBC counts in pregnant individuals.
  • Monitoring WBC counts using these updated intervals is clinically significant for early detection of infections and adverse pregnancy outcomes.
  • The findings underscore the importance of context-specific reference ranges in obstetric care.