Corticosteroid-induced leukocytosis in pregnancy: A prospective observational study
- Author:
Voon Hian Yan
;
Leong May Shi
;
Li Chean Wen
;
Mohamad Adam Bujang
;
Haris Njoo Suharjono
- Publication Type:Original article
- Keywords:
Corticosteroid;
dexamethasone;
leucocytosis;
neutrophillymphocyte ratio;
pregnancy;
preterm labour
- MeSH:
Leukocytosis;
Pregnancy
- From:
The Medical Journal of Malaysia
2017;72(5):259-263
- CountryMalaysia
- Language:English
-
Abstract:
Background: In the course of managing preterm labour,
increasing trends of total white cell count raises concern for
the obstetrician, suggesting a possible underlying
infectious aetiology. Although mild leukocytosis is expected
in pregnancy, the patterns of increment after corticosteroid
administration are not well described beyond animal models
and in a small number of human studies.
Methods: Seventy-three consecutive patients who required
antenatal corticosteroids for either preterm labour or
prelabour caesarean section were recruited and given a
standard course of 12mg dexamethasone phosphate, twelve
hours apart. Venous blood samples were taken before
administration, at six hours and 36 hours after the first dose
of dexamethasone.
Results: The total white count trend was 10.31±2.62 at
baseline, 11.44±3.05 at six hours and 12.20±3.49 at 36 hours.
Neutrophil-lymphocyte ratio was 3.60±1.31, 8.73±3.63 and
3.24±1.49 respectively, reflecting relative neutrophilia and
lymphopenia which normalised by 36 hours.
Conclusion: In contrast to previous studies, we found only a
slight increment in total white cell count of about 10%. The
marginal changes described in our study would not
normally raise any clinical concern, although vigilance
should be exercised if higher levels were observed.
