Dr. Aruna Ashok MBBS, MS OG, DNB OG
- Clinical Director
Aruna Ashok | 15 Sep 2023
Higher levels of white blood cells (WBC) are the normal part of pregnancy, like other physiological changes. The WBC is otherwise referred to as a leukocyte. The white blood cell levels are part of the immune system, which originates from the bone marrow. These cells are elevated in pregnant women due to the increased blood volume in their bodies. Hence, it is normal to have higher levels of WBCs throughout the pregnancy, especially during labour and soon after childbirth. The WBCs play a crucial role in guarding the maternal body from infections and other harmful substances.
The elevated levels of WBCs are the normal part of pregnancy, until it is accompanied by other symptoms like pain and fever. The symptoms can sometimes be an indicator of potential infection in the maternal body, which requires medical help. If left untreated, it could significantly harm both the mother and the developing fetus.
This blog lets you understand a healthy range of high white blood cell (WBC) count in pregnancy, what causes the high WBC count, risks associated with it and when to seek medical help.
The normal and moderate range of white blood cell (WBC) may differ in all three trimesters of pregnancy. During the first trimester, the WBC is considered to be minimally elevated when compared to the non-pregnant individual. The range could get even higher in the third trimester.
Normal WBC level in non-pregnant women
Normal WBC level in non-pregnant women can generally range between 4,500 and 11,000/nm3.
Normal WBC level in the First Trimester
The WBC levels may tend to get elevated slightly when compared to those of non-pregnant women. The levels usually remain closer to or within the range of non-pregnant women.
Normal WBC level in the Second Trimester
The WBC levels may continue to increase in the second trimester of pregnancy. This may generally range between 6,000 and 14,000/nm3.
Normal WBC level in the Third Trimester
The WBC levels may often be at their peak in the third trimester of pregnancy. The levels may usually range between 12,000 and 18,000/nm3.
Abnormal WBC level in non-pregnant women
When the WBC levels are elevated, typically above 11,000/nm3 in non-pregnant women, it is considered abnormal. This may require professional medical attention.
Abnormal WBC level in pregnant women
When the WBC levels are elevated, typically above 18,000/nm3 (third trimester) in pregnant women, it is considered abnormal. This may require professional medical attention.
The following are some of the common causes of high white blood cell (WBC) count in pregnancy. They are:
Let's unravel this mystery together.
The spiking levels of white blood cells are the normal physiological response of the maternal body. This may typically happen because of the increased blood volume and hormonal changes. The WBCs may also increase as the response of the maternal body to guard both the developing fetus and the pregnant woman from infections. These levels are most often elevated after 4 months of pregnancy. It can also return to normal levels soon after childbirth, typically in a week or two of postpartum.
White blood cells, being a significant part of the body’s immune system, any changes in them can lead to spiking levels of WBCs. When we say bodily changes, we are talking about infections. The most common infections in pregnant women may include urinary tract infections (UTIs), bacterial vaginosis, viral infections, and Group B Streptococcus (GBS) infections. Even though most of these are generally manageable, infections like syphilis can lead to serious complications in pregnancy, especially if left untreated.
It is essential to understand that even though infections are the common cause of spiking levels of WBCs, stress can also play a significant role.
Inflammation while pregnant can be another cause of a high white blood cell (WBC) count. The condition is known as leukocytosis. Though mild to moderate spiking levels of WBC are common during pregnancy, too high spiking levels may indicate underlying medical conditions or inflammation. Individuals with autoimmune diseases like lupus and rheumatoid arthritis can also experience inflammation, which can cause higher levels of WBCs. Likewise, preeclampsia can also contribute to the spiking levels of WBCs while pregnant.
Both emotional and physical stress can be significant factors for spiking levels of WBCs. Since pregnancy is a physiological stress, it contributes to the increased WBC production. Similarly, illnesses like fever, surgery, or injury can also contribute to increasing WBCs.
Certain medications like corticosteroids play a role in spiking the levels of WBCs in both pregnant and non-pregnant individuals. These medications are used to treat conditions like asthma, allergies, autoimmune diseases, and certain cancers. The WBCs can return to normal levels typically within a few days after the administration.
Conditions like leukaemia and myeloproliferative disorders (MPNs) can be the potential factors for increasing white blood cells (WBC). Even though too many levels of WBCs are the common cause of inflammation and infection, these two conditions can also be contributing factors for extremely high WBCs.
The following are some of the risks associated with a high white blood cell (WBC) count while pregnant:
While extremely increased levels of WBC while pregnant are a sign of inflammation and infection, the persistently increasing levels are associated with certain complications. The complications may include preeclampsia, low birth weight, gestational hypertension, and preterm birth. Timely diagnosis of the appropriate cause of high WBCs is essential for the well-being of both the pregnant individual and the developing fetus.
A higher-than-normal WBC can pose the potential risk of infections. Respiratory infections like pneumonia, sepsis, kidney infections, and urinary tract infections (UTIs) have a strong association with elevated levels of white blood cells. These can negatively impact the well-being of both the pregnant individual and the developing fetus.
Untreated infections while pregnant can certainly lead to higher WBCs, which can pose several risks to both the mother and the baby. They are premature rupture of membranes (PROM), preterm labour, postpartum infection, amniotic sac infection (chorioamnionitis) and other complications. The untreated infection can compromise the integrity of the amniotic sac, leading to rupture even before full-term. It can also induce the uterus to contract prematurely. Both of which can potentially lead to preterm deliveries.
The extreme spiking levels of WBC in pregnant women have a strong association with placental issues. While a mild to moderate increase in WBCs during pregnancy is normal, the sudden or extreme spiking levels can indicate certain complications, including placental issues like oligohydramnios and placenta previa.
High white blood cell (WBC) counts are associated with an increased risk of intrauterine growth restriction (IUGR). IUGR is a serious medical condition found in pregnant women where a fetus does not reach the growth milestones in the mother’s womb. The condition is often linked to heightened inflammatory response, which can potentially cause long-term health issues in the baby.
Beyond routine infections, the increasing levels of WBCs have been associated with complications like cesarean delivery, hypertensive disorders, and even miscarriage. Studies show that spiking levels of white blood cells in pregnant women, especially in the first trimester, pose the potential risk of gestational diabetes, preterm delivery, and other complications.
A moderately spiking white blood cell (WBC) count is a common occurrence in pregnant women. However, if the levels have a significant increase along with certain symptoms like pain, fever, chills, and unusual discharge, it is time to visit a healthcare professional.
Similarly, if the WBC levels are extremely elevated beyond their normal range for the trimester, it could be a significant sign for medical help.
Again, if the white blood cells are persistently elevated without normal fluctuations, it is an essential sign of medical help requirement.
It is common for pregnant women to be diagnosed with elevated WBC count, unless it is accompanied by fever, fatigue, pain, and other abnormal symptoms. Also, it is essential to understand that the range considered normal WBC count may significantly vary from woman to woman. Never panic unless your healthcare provider talks to you about it.
1: What is the moderate range of elevated white blood cell (WBC) count during pregnancy?
The moderate range of elevated white blood cell (WBC) count during pregnancy is around 12,000 to 18,000/nm3, especially in the third trimester. The range is usually considered normal. However, the WBC count beyond 11,000/nm3 while pregnant should be evaluated by the healthcare provider.
2: Does physical activity impact white blood cell (WBC) count during pregnancy?
The answer to the question is yes. Physical activity, particularly intense workouts, can impact white blood cell (WBC) count during pregnancy. It can cause temporary variations in the WBC count.
3: Does obesity cause a negative impact on the white blood cell (WBC) levels during pregnancy?
The answer to the question is yes. Obesity can cause a negative impact on the levels of white blood cells (WBC) during pregnancy. Studies show that the WBC count in obese women is typically higher than that of non-obese women. The increase has a certain association with inflammatory markers.
4: Can I minimise elevated WBC count through diet while pregnant?
While diet can play a role in enhancing overall health, it cannot significantly minimise the elevated levels of WBC count, especially during pregnancy. An elevated WBC count should be identified and addressed by medical guidance.
5: Can a higher WBC count lead to blood cancer?
The answer to the question is yes. The higher WBC count can certainly lead to blood cancer (leukaemia), but it is not the only indicator. Inflammation, infection, and certain medications can also contribute to elevating levels of WBC. However, persistent and significant spiking WBC levels may require further investigation for blood cancers.
