Cord blood parameters change in pregnancy induced hypertension

Purnima Meher, Sitanshu Kumar Meher, Sunil Kumar Jena


Background: Pregnancy induced hypertension (PIH) is a multisystem disease of unknown etiology which affects only human beings. It poses several problems to both mother and child. Complications in newborns like intrauterine death (IUD), intrauterine growth retardation (IUGR), perinatal asphyxia, neonatal sepsis and bleeding disorders are associated with toxaemia of pregnancy. To decrease the perinatal morbidity and mortality, babies of hypertensive mothers should be carefully monitored and managed. Aim of this study was to establish the changes in total platelet count, reticulocyte count and absolute neutrophil count of umbilical cord blood in pregnancy induced hypertension as compared to normotensive mothers.

Methods: This case-control study was conducted among 60 subjects including 30 case (diagnosed cases of pregnancy induced hypertension) and 30 control (normotensive pregnant women). The case group was again categorized into three subgroups – gestational hypertension (06), pre-eclampsia (16) and eclampsia (08). In all the subjects, 2 ml of umbilical cord blood anticoagulated with EDTA was collected and haematological tests for reticulocyte count, total platelet count (TPC) and absolute neutrophil count was done.

Results: There was significant decrease in TPC (p<0.01) and absolute neutrophil count (p<0.01), but significant rise in reticulocyte count (p<0.05) in umbilical cord blood of babies born to hypertensive mothers compared to normotensive mothers

Conclusions: From this study, it can be concluded that newborns of hypertensive mothers carry risks for infection and bleeding complications. So, these simple haematological tests can be done at early stage in neonates to reduce possible perinatal morbidities and mortality.


Absolute neutrophil count, Hypertension, TPC

Full Text:



Altman D, Carroli G, Duley L. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomizedplacebocontrolled trial. Lancet. 2002;359:1877-90.

World Health Organisation. World Health Report: Make Every mother, and Child Count. Geneva: World Health Org. 2005.

Sibai BM. Hypertension in pregnancy. In:Gabbe SG, Niebly JR, Simpson JL(eds). Obstetrics Normal & Problem Pregnancies. Churchill Livingstone. 1996;935-87

Padden MO. HELLP Syndrome; recognition and perinatal management. Am Fam Physian. 1999;60(3):827-36.

Heilmann L, Rath W, Pollow K. Fetalhemorheology in normal pregnancy and severe preeclampsia. Clin Hemorheol Microcirc. 2005;32:183-90.

Kaur AP, Saini AS, Dhillon SP. HELLP syndrome associated with moderate to severe PIH/Eclampsia. J. Obstet&Gynecol, India. 2003;53(2):165.

Christensen RD, Henry E, Wiedmeier SE, Stoddard RA, Sola-Visner MC, Lambert DK, et al. Thrombocytopenia among extremely low birth weight neonates: data from a multihospital healthcare system. J Perinatol. 2006;26:348-53.

Pritchard JA, Cunningham FG, Pritchard SA, Mason RA. How often does maternal preeclampsia-eclampsia incite thrombocytopenia in the fetus? Obstet Gynecol. 1987;69:292-5.

Moodley J, Naidu S, Chetty D, Adhikari M, Gouws E. Neonatal thrombocytopenia in preeclamptic women with low platelet counts. Hypertens Pregnancy. 1996;15:297-304.

Thiagarajah S, Bougeois J, Harbert GM Jr, caudle MR. Thrombocytopenia in preeclampsia: associated abnormalities and management principles. Am J Obstet Gynaecol. 1984;150:1-7.

Kleckner HB, Giles HR, Corrigan JJ. The association of maternal and neonatal thrombocytopenia in high risk pregnancies. Am J Obstet Gynecol. 1977;128:235-8.

Burrows RF, Andrew MD. Neonatal thrombocytopenia in the hypertensive disorders of pregnancy. Obstet Gynaecol 1990;76:234-7.

Philip AG, Tito AM , Increased nucleated red blood counts in small for gestational age infants with very low birth weight. Am J Dis Child. 1989;143:164-9.

Christna C, Irene R, Luis B. Fetal and maternal angiogenic/ antiangiogenic factors in normal and preeclamptic pregnancy, Growth Fact. 2009;27(6):345-51.

Paterakis GS, Lykopoulou L, Papassotiriou J, Stamulakatou A, Kattamis C, Loukopoulos D. Flow-cytometric analysisof reticulocytes in normal cord blood. Acta Haematol. 1993;90(4):182-5.

Redzko S, Przepiesc J, Zak J, Turowski D, Urban J, Wysocka J. Cord blood reticulocytes and reticulocyte subtypes in normal and complicated pregnancy. Med Wieku Rozwoj. 2002;6(2):145-53.

Troeger C, Holzgreve W, Cadewig A, Zhang XY, Hahn S. Examination of maternal plasma erythropoietin and activinA concentrations with regard to circulatory erythroblast levels in normal and pre-eclamptic pregnancies. Fetal DiagnTher. 2006;21:56-60.

Doron MW, Makhouf RA, Katz V, Lawson E, Stiles AD. Increased incidence of sepsis at birth in neutropenic infants of mothers with preeclampsia. J Pediatr. 1994;125:452-8.

Engle WD, Rosenfield CR. Neutropenia in high risk neonates. J Pediatr. 1984;105:982-4.

Koinig JM, Yoder CM. Neonatal neutrophils: the good, the bad, and the ugly. Clin Perinatol. 2004:31;39-51.

Christensen RD. Calhoun DA. Congenital neutropenia. Clin Perinatol. 2004;31:29-38.

Koenig JM, Christensen RD. The mechanism responsible for diminished neutrophil production in neonates delivered of women with pregnancy induced hypertension. Am J ObstetGynecol. 1991;165:467-73.

Kunz TB, Christensen RD, Stegner R, Duff P, Koenig JM. Fas and Fas ligand expression in maternal blood and umbilical cord blood in preeclampsia. Pediatr Res. 2001;50:743-9.

Sivakumar S, Bhat V, B. & Badhe, B.A. Indian J Pediatr. 2007;74:623-5.

Bolat A, Gursel O, Kurekci E, Atay A, Ozcan O. Blood parameters changes in cord blood of newborns of hypertensive mothers. Eur J Pediatr. 2003;172:1501-9.

Makhlouf RA, Doron MW, Bose CL, Price WA, Stiles AD. Administration of granulocyte colony stimulating factor to neutropenic low birth weight infants of mothers with pre-eclampsia. J Pediatr. 1995;126:454-6.

La Gamma EF, Aplan O, Kocherlakota P. Effect of granulocyte colony-stimulating factor on pre-eclampsia associated neutropenia. J Pediatr. 1995;126:457- 9.

Cadnapaphornchai M, Faix RG. Increased nosocomial infection in neutropenic low birth weight infants of hypertensive mothers, J Pediatr 1992;121:956-61.