Neutrophils are a type of white blood cell, also known as leukocytes, that play a role in the body’s immune system. These cells are part of the innate immune response, acting as a first line of defense against invading pathogens like bacteria and fungi. They are the most abundant type of white blood cell, making up 40% to 70% of all white blood cells in humans. Neutrophils are actively involved in fighting infection and inflammation throughout the body.
Neutrophils and Their Role in Pregnancy
Neutrophils are a type of granulocyte, identifiable by their neutral staining properties and segmented nuclei. Produced in the bone marrow, these cells circulate in the bloodstream, rapidly responding to infection or injury. They are among the first immune cells to arrive at an affected site, where they engulf and destroy microorganisms through phagocytosis. Neutrophils can also release enzymes and web-like structures of DNA and proteins, called Neutrophil Extracellular Traps (NETs), to trap and neutralize pathogens.
During a healthy pregnancy, the total white blood cell count commonly increases, a phenomenon known as physiological leukocytosis. This rise is primarily due to an increase in neutrophil numbers, which can go up by approximately 55% within the first two months of gestation. This is a normal physiological adaptation to pregnancy, driven by factors like increased estrogen levels, physical and emotional stress, and the body’s preparation for potential blood loss during delivery.
The normal range for white blood cells in non-pregnant adults is between 4,500 and 11,000 cells per microliter (µL). In pregnant individuals, the white blood cell count can increase, with normal values ranging from 5,000-12,000 cells/µL in early pregnancy and potentially reaching 14,000-16,000 cells/µL, or up to 20,000 cells/µL, near term. This increase in neutrophils contributes to heightened immune surveillance, protecting both the pregnant individual and the developing fetus from infections.
Reasons for Elevated Neutrophils Beyond Normal Pregnancy
While an increase in neutrophil levels is a normal physiological change during pregnancy, abnormally high or symptomatic counts can indicate an underlying condition. Pathological causes of elevated neutrophils include various infections. Common infections such as urinary tract infections (UTIs) or respiratory infections can trigger a significant immune response, leading to a noticeable increase in neutrophil numbers.
Inflammatory conditions can also contribute to abnormally high neutrophil counts. For example, preeclampsia, a serious condition characterized by high blood pressure during pregnancy, is associated with an increased inflammatory response and higher total leukocyte counts, mainly due to neutrophils. Elevated neutrophil counts in the first and second trimesters have even been suggested as potential predictive markers for gestational diabetes and late pregnancy preeclampsia. Other inflammatory conditions like appendicitis or nephritis can also elevate neutrophil counts.
Beyond infections and inflammatory conditions, other factors can also elevate neutrophils. These include excessive physical or emotional stress, dehydration, and certain medical conditions such as adrenal hyperfunction or hyperthyroidism. Certain medications, including corticosteroids, beta-agonists, and lithium, are also known to increase white blood cell counts, contributing to elevated neutrophil levels. Rarely, extremely high white blood cell counts (above 20,000 cells/µL) or concerning symptoms may warrant further investigation to rule out more serious conditions, such as certain malignancies.
Recognizing Concerning Symptoms and Seeking Care
While a moderate increase in neutrophil count is a normal part of pregnancy, certain symptoms may suggest an underlying issue requiring medical attention. These concerning symptoms can include fever, a common indicator of infection, or any new pain. Unusual discharge, persistent fatigue, or unexplained weight loss also warrant evaluation. Swelling, bruising, or bleeding that is not typical should also prompt discussion with a healthcare provider.
Difficulty breathing or wheezing could indicate a respiratory infection or another pulmonary concern. Night sweats are another symptom that can be associated with infections or other conditions when present with elevated neutrophils. Since a high white blood cell count during pregnancy often has no noticeable symptoms, regular prenatal blood tests monitor these levels. If any of these symptoms arise, or if there are any other concerns, communicate them promptly to a healthcare provider. A doctor can then interpret blood test results within the context of overall health and symptoms to determine if further diagnostic tests or medical intervention are necessary.
Addressing High Neutrophil Levels During Pregnancy
When elevated neutrophil levels during pregnancy are identified as beyond the normal physiological range, management focuses on addressing the underlying cause. Treatment strategies are tailored to the specific condition diagnosed. For instance, if a bacterial infection is identified, antibiotics are prescribed to clear it. In cases of inflammatory conditions like preeclampsia, management involves monitoring and interventions to control blood pressure and other symptoms, safeguarding maternal and fetal health.
Should other causes such as dehydration or medication side effects be identified, appropriate adjustments will be made, involving rehydration or modifying medication regimens under medical supervision. The goal is to mitigate risks to the pregnancy by resolving the root cause. With proper medical care and timely intervention, many cases of pathologically high neutrophil levels can be managed effectively, leading to positive outcomes for both the pregnant individual and the baby.