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Haptoglobin in pregnancy: Trimester-specific reference intervals.

M Natalia Chaves Rivera1, Ibrahim Choucair2, Michael A Vera3

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|March 4, 2025
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Pregnancy can lower haptoglobin levels, especially in the second trimester. This study establishes trimester-specific reference intervals for haptoglobin to aid in accurate diagnosis during pregnancy.

Keywords:
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Area of Science:

  • Clinical Chemistry
  • Reproductive Medicine
  • Hematology

Background:

  • Physiologic changes during pregnancy can alter serologic markers.
  • Lower haptoglobin values in pregnancy may be mistaken for hemolysis.

Purpose of the Study:

  • To determine trimester-specific reference intervals (RIs) for haptoglobin during pregnancy.
  • To investigate potential misdiagnosis of hemolysis due to pregnancy-related haptoglobin variations.

Main Methods:

  • A quality improvement project analyzed 401 serum samples from pregnant patients.
  • Haptoglobin levels were measured using Roche Cobas 8000 systems.
  • Statistical comparison of haptoglobin between trimesters was performed using the Mann-Whitney test.

Main Results:

  • Nonparametric RIs for haptoglobin were established for each trimester.
  • A significant difference in haptoglobin distribution was observed in the second trimester (median, 98 mg/dL) compared to the first (median, 113.5 mg/dL) and third (median, 112.5 mg/dL) trimesters.

Conclusions:

  • While overall pregnancy haptoglobin RIs align with nonpregnant populations, a significant dip occurs in the second trimester.
  • Lower second-trimester haptoglobin may lead to misdiagnosis of intravascular hemolysis.
  • Trimester-specific RIs are crucial for accurate interpretation of haptoglobin levels in pregnant individuals.