Monocytes

Monocytes are a type of white blood cell that play a crucial role in the immune system's defense mechanisms. During pregnancy, significant changes occur in the maternal immune system and Physiology to accommodate the development of the growing baby, while maintaining maternal Health.​ Understanding the role of monocytes and pregnancy is essential for comprehending the intricate interplay between immunity and gestation.

Monocyte Testing

The absolute monocyte count tells you the total count of monocytes in the sample. The monocyte percentage tells you what percentage of white blood cell count is made up of monocytes. It is found in the complete blood count (CBC) with differential panel.

The percentage is arguably more accurate that absolute, as it takes into account the total production of white blood cells and compares the amount of monocytes to this total. 

Monocytes, lacking granules, fall under the category of agranulocytes. Accounting for 2% to 10% of all leukocytes in the human body, monocytes play a crucial role in mitigating damage caused by inflammation and diseases.

During the acute immune response, neutrophils take the lead, with monocytes following to clean up damaged cells. Elevated levels of monocytes are observed during the recovery phase of a disease.

Further differentiation of monocytes results in the formation of macrophages and dendrites.

• Macrophages, originating from monocytes in the bloodstream, migrate to the tissues to fulfill their functions.
• Dendrites play a vital role in regulating the adaptive immune system, initiating responses related to immune system memory, and promoting tolerance to pathogens.

Monocytes in Pregnancy

​In pregnancy monocyte levels increase by approximately 38%.

Serum monocyte levels remain elevated until 20 weeks, and then decrease slightly in the third trimester. It is normal for there to be a slight increase in the proinflammatory pattern in pregnancy.

Macrophages can be found in the maternal-fetal interface. Macrophages play a positive role in embryo implantation, placental formation, embryonic development, and delivery processes.

Dendritic cells play a critical immuno-modulating role in pregnancy, which requires the maternal immune system to tolerate the fetus and at the same time to maintain adequate defense against pathogens.

​An increased monocyte-to-lymphocyte ratio is a common finding in pregnancy.

High Monocytes in Pregnancy

Elevated monocytes, outside of normal rises, is associated with an increase in preeclampsia risk. Interestingly you’ll also see low monocytes with preeclampsia as more monocytes are converted to macrophage and dendrite lineages. 

Elevated monocytes may persist after gestational hypertension disease. 

Most Common Causes of High Monocytes in Pregnancy

• Acute Infection Recovery
• Chronic Inflammatory Diseases
• Liver Damage
• Autoimmune Disease
• Adrenal Hyperfunction
• Myeloproliferative Disease
• Preeclampsia
• Environmental Chemical Exposure/Smoking
• Physical Injury/Tissue Damage
• Certain Medications (corticosteroids)

Low Monocytes in Pregnancy

Decreased monocytes counts throughout pregnancy have been associated with the development of gestational diabetes mellitus (GDM), macrosomia, and the chronic inflammation associated with GDM. First trimester monocyte counts have been shown to be an early diagnostic marker for GDM. 

Most Common Causes of Low Monocytes in Pregnancy

• Chronic Inflammation
• Chronic Infections
• Adrenal Hypofunction
• Autoimmune Disease
• Nutritional Deficiencies (Vitamin D, Vitamin A, Zinc)
• Certain Medications (Antibiotics, Antivirals)
• Blood Disorders
• Bone Marrow Disorders
• Genetics

Want to Know More...

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Medical Disclaimer:
This content is for educational purposes only and is intended for licensed medical professionals. It is based on current research, subject to change, and not intended to diagnose, treat, or prevent any medical condition. This information does not replace consultation with a qualified healthcare provider. Seek professional medical evaluation and treatment from a licensed provider. Use of this information is at your own risk.​

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