Neutrophils

Neutrophils are the first line of defense in combating infections and maintaining overall health. In the realm of pregnancy, every physiological change holds profound significance, including alterations in neutrophil levels. 

Neutrophil Testing 

​The absolute neutrophil count tells you the total count of neutrophils in the sample. The neutrophil percentage tells you what percentage of the white blood cell count is made up of neutrophils. Both analytes are 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 neutrophils to this total. 

Neutrophils are a type of granulated white blood cell. They originate in bone marrow from myeloid progenitor cells. Neutrophils are either segmented or banded (Nonsegmented). Banded neutrophils are young neutrophils. Banded neutrophils are increased in acute infection, with or without an increase in total WBC count. Segmented neutrophils are mature blood cells. The primary job of neutrophils is to identify microbial infections, trap, neutralize, and kill them through phagocytosis. 

Neutrophils are the “first line of defense” in the immune system. They are phagocytic cells, meaning they can engulf and digest microorganisms such as bacteria and fungi. When neutrophils encounter pathogens, they can release their DNA, along with antimicrobial proteins, into the extracellular space. This results in the formation of NETs. NETs are a web-like structure that ensnares and immobilizes pathogens, preventing their spread. This process is called NETosis.

Neutrophils in Pregnancy

In pregnancy there is an increase in neutrophil production and a decrease in neutrophil apoptosis. This causes a net increase in neutrophil counts by 55% within the first 2 months of pregnancy. Numbers continue to increases plateauing at the end of the second trimester.​ Studies have shown that these WBCs help with placental development and maintaining maternal-fetal tolerance. 

During pregnancy, neutrophils display a unique Behavior called chemotaxis, guiding them to sites of anything or inflammation. This process is delicately regulated by progesterone to prevent an exaggerated immune reaction against the developing fetus. Additionally, progesterone reduces a process known as Netosis. Overall, pregnancy shifts the immune response towards tolerance to accommodate the semi-allogenic fetus,​ preventing rejection while potentially increasing susceptibility to certain infections.

High Neutrophils in Pregnancy

In a healthy pregnancy neutrophils are between 60 - 80% of total white blood cell counts. 

Neutrophil counts >6.0 X 10*9 /L in the first trimester has been identified as a predictive marker for gestational diabetes, and late pregnancy preeclampsia.

It is suggested the elevated neutrophils counts in the second trimester may be a useful predictor of preeclampsia. 

Elevated neutrophils in the third trimester have been associated with an increased risk of placental dysfunction, leading to small for gestational age fetal growth.

Most Common Causes of High Neutrophils in Pregnancy 

• Acute Infections
• Acute Allergic Reactions
• Dehydration
• Polycythemia
• Adrenal Hyperfunction
• Low Progesterone
• Hyperthyroidism
• Stress
• Polycythemia
• Iron Overload/Hemochromatosis
• Autoimmune Disease
• Inflammatory Bowel Diseases
• Physical Trauma
• Recent Intense Physical Exercise
• Sedentary Lifestyle
• Irregular Sleep Patterns
• Mycotoxin Exposure
• Environmental Toxin Exposure
• Nutritional Deficiencies (Zinc, Magnesium)
• Diabetic Ketoacidosis
• Certain Medications

Low Neutrophils in Pregnancy

​Low WBC (<9× 10^9/L), low neutrophil count, and neutrophil-to-lymphocyte ratio are decreased in women with Cholestasis in the third trimester.

Decreased neutrophils during pregnancy can lead to abnormal development of the fetal-maternal unit, decrease embryo development, and cause trophoblast invasion and arterial spiraling dysfunction. 

Neutropenia in pregnancy has been associated with preterm birth.

Most Common Causes of Low Neutrophils in Pregnancy

• Chronic Infections (Latent Viral, Candida)
• Dysbiosis
• Autoimmune Disease
• Chronic Inflammation
• Adrenal Hypofunction
• Antibiotic Use
• Certain Medications
• Advanced Maternal Age
• Excessive Intense Exercise
• Chronic Mycotoxin Exposure
• Environmental Toxin Exposure
• Nutritional Deficiencies (Copper, Folate, Vitamin B12)
• Hypothyroidism
• Genetics

Want to Know More....

​Check Out My Advanced Lab Analysis in Pregnancy Practitioner Course
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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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