Abstract
Profound changes occur during pregnancy in the maternal hematopoietic system in order
to meet the needs of the developing fetus and of the mother. By presenting the available
data in one review, this review links all known hematopoietic events that occur during
normal and certain abnormal pregnancies. Erythropoietin and erythrocyte production
are increased during normal pregnancy while erythrocyte mass per unit of body weight
remains constant throughout the entire pregnancy, and hemoglobin and hematocrit continuously
decrease into the third trimester. Erythrocyte life span is decreased during normal
pregnancy due to ‘emergency hemopoiesis’ in response to elevated erythropoietin levels.
In preeclampsia, maternal erythrocytes are of similar to non-pregnant state age distribution,
while fetal erythrocytes are of younger age distribution than in normal pregnancy.
In gestational diabetes, maternal erythrocyte age distribution is similar to that
of normal pregnancy. In multifetal pregnancy, maternal erythrocyte age distribution
is younger than that of normal pregnancy.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Aging of the erythrocyte.in: Cristafolo V. Handbook of cell biology of aging. CRC Press, Florida1985: 317-340
- The aging of the red blood cell. A multifactorial process.Blood Cells. 1988; 14: 7-15
- The mechanism of red cell aging. I. Relationship between cell age and specific gravity evaluated by ultracentrifugation in a discontinuous gradient.J. Lab. Clin. Med. 1967; 69: 659-674
- Altered enzyme function and premature sequestration of erythrocytes in aged individuals.Blood Cells. 1988; 14: 93-98
- The relationship of red cell enzymes to red cell life-span.Blood Cells. 1988; 14: 69-75
- Morphologie des membranes de erythrocytes jeunes et ages. Observations au microscope electronique.Compt. Rend. Soc. Biol. 1961; 253: 12-18
- Disquisition critical et experimentales de sanguinis quantitate in mamamlium corpore exstantis.Haliss. Typ. Exp. Gesb. Schwet. 1857; 1: 36
- Hematologic changes associated with pregnancy.Clin. Obstet. Gynecol. 1979; 22: 485-498
- Plasma and blood volume in pregnancy.J. Am. Med. Assoc. 1915; 65: 779
- Blood volume changes in normal pregnant Nigerian women.J. Obstet. Gynaecol. Br. Commonw. 1966; 73: 717-723
- Blood volume during pregnancy: significance of plasma and red cell volumes.Am. J. Obstet. Gynecol. 1967; 98: 393-403
- Anemia in pregnancy – a reappraisal.Obstet. Gynecol. Surv. 1973; 28: 769-793
- Mechanism of red blood cell aging: relationship of density and cell age.Am. J. Hematol. 1993; 42: 46-52
- Some characteristics of human red blood cells separated according to their size: a comparison with density fractionated red blood cells.Am. J. Hematol. 1988; 28: 232-238
- Determination of density distribution of red cell population.J. Lab. Clin. Med. 1964; 64: 668-674
- Age population distribution of erythrocytes in young and old healthy donors.Exp. Gerantol. 1990; 25: 413-422
- Density distribution of erythrocytes is not subject to the ABO blood group antigen component of its membrane.Am. J. Hematol. 1995; 48: 139-140
- Number and distribution density of ABH and MN antigen sites on young and old human erythrocyte surfaces.Life Sci. 1988; 43: 683-689
- Age distribution of erythrocyte population in late pregnancy.Gynecol. Obstet. Invest. 1990; 30: 147-149
- Changes in age distribution of erythrocytes during pregnancy. A longitudinal study.Gynecol. Obstet. Invest. 1993; 36: 141-144
- Life span of erythrocytes in late pregnancy.Obstet. Gynecol. 1992; 80: 123-126
- The effect of erythropoietin on age distribution of erythrocytes in pregnant mice.J. Feto. Mat. Invest. 1996; 6: 107-109
- Changes in erythrocyte volume and shape in pregnancy.Br. J. Obstet. Gynecol. 1982; 89: 1018-1020
- Increased erythrocyte fragility in association with osmotic changes in pregnancy serum.J. Reprod. Fertil. 1968; 16: 323-324
- Comparative study of erythrocyte deformability in maternal and cord blood.Am. J. Perinatol. 1995; 12: 39-43
- The erythrocyte deformability in maternal and cord blood is determined by erythrocyte density.Am. J. Perinatol. 1996; 13: 255
- Factors that accelerate or retard red cell senescence.Blood. 1988; 14: 47-59
- Erythrocyte production and destruction during pregnancy.Am. J. Obstet. Gynecol. 1960; 79: 750-757
- 51Chromium uptake as a function of red cell age.J. Lab. Clin. Med. 1964; 64: 668-674
- Reticulocyte size and erythropoietic stimulation.Proc. Soc. Exp. Biol. Med. 1961; 107: 887-891
- Erythropoiesis in pregnancy.Br. J. Hematol. 1986; 64: 595-599
- Regulation of erythropoiesis in fetus and mother during normal pregnancy.Obstet. Gynecol. 1982; 60: 77-81
- Humoral regulatuion of erythropoiesis. VII. Shortened survival of erythrocytes produced by erythropoietine or severe anemia.Proc. Soc. Exp. Biol. Med. 1961; 107: 884-886
- Macrocytosis resulting from early denucleation of erythroid precursors.Blood. 1964; 24: 582-591
- Turnovers of erythrocytes and plasma proteins in mammals.Nature. 1960; 188: 37-40
- Serum immunoreactive erythropoietin in health and disease.J. Perinat. Med. 1995; 23: 13-17
- The effect of plethora on erythropoietin levels.Proc. Soc. Exp. Biol. Med. 1980; 163: 36
- Endocrine control of maternal and fetal erthropoiesis.Can. Med. Ass. J. 1968; 98: 844
- Prolongation of RBC survival in the hypophysectomized rat.Proc. Soc. Exp. Biol. Med. 1971; 138: 152-156
- Changes in serum immunoreactive erythropoietin during menstrual cycle and normal pregnancy.Br. J. Obstet. Gynecol. 1983; 90: 304
- Blood rheology and pregnancy.Bailliere Clin. Haematol. 1987; 1: 777-799
- Erythropoiesis in pregnancy.J. Perinat. Med. 1995; 23: 39-45
- Iron and erythropoiesis in normal subjects and in pregnancy.J. Perinat. Med. 1995; 23: 47-50
- Anemia of pregnancy.Med. Clin. North Am. 1992; 76: 631
- Anemia of pregnancy.Clin. Perinatol. 1995; 22: 593-607
- Erythropoiesis in the postpartum period.J. Perinat. Med. 1995; 23: 51-59
- Blood volume changes in pregnancy and the pueperium. I. Does sequestration of red blood cells accompany parturiation?.Am. J. Obstet. Gynecol. 1960; 80: 956-963
- Neocyolysis: physiological down-regulation of red-cell mass.Lancet. 1997; 349: 1389-1390
- Decreased production of red cells in human subjects exposed to microgravity.J. Lab. Clin. Med. 1995; 125: 442-449
- Control of the red blood cell mass in spaceflight.J. Appl. Phytsiol. 1996; 81: 98-104
- Decreased expression of integrin a,b and CD 36 on circulating sickle reticulocytes and nucleated red cells following therapy with high dose erythropoietin.Blood (suppl.). 1994; 15 (Abstract): 1601
- Erythrocyte cation metabolism in preeeclampsia.Am. J. Obstet. Gynecol. 1989; 161: 441-445
- Alterations in erythrocyte chloride content accompanying the changes in erythrocyte hydration and potasium content in normal human pregnancy: a comparison with pregnancy induced hypertension.Br. J. Obstet. Gynecol. 1993; 100: 679-683
- Hemodynamic and metabolic studies of a case of toxemia of pregnancy.Am. J. Obstet. Gynecol. 1977; 127: 206-208
- Studies of colloid osmotic pressure in pregnancy-induced hypertension.Am. J. Obstet. Gynecol. 1979; 135: 308-311
- Erythrocyte morphology in women with severe preeclampsia and eclampsia. Preliminary observations with scanning electron microscopy.Am. J. Obstet. Gynecol. 1985; 153: 458-463
- Plasma lipids and cholesterol esterification rate during pregnancy.Obstet. Gynecol. 1984; 63: 20
- Density distribution of erythrocytes population in preeclampsia.Gynecol. Obstet. Invest. 1992; 33: 94-97
- Comparison of age distribution of umbilical cord erythrocytes in preeclamptic women versus women with uncomplicated pregnancy.Obstet. Gynecol. 1996; 88: 180-183
- Phagocytic cell activity in preeclampsia.Acta Obstet. Gynecol. Scand. 1988; 67: 499-504
- Effect of red cells on the coagulation of blood in normal and preeclamptic pregnancies.Am. J. Obstet. Gynecol. 1999; 180: 402-405
- Erythrocyte life span, preeclampsia and hypercoagulability.Am. J. Obstet. Gynecol. 1999; 181: 1276
- Increased red cell aggregation in diabetes mellitus: association with cardiovascular risk factors.Diabet. Med. 1992; 10: 21-26
- Blood rheology and albumin excertion in diabetic pregnancy.Diabet. Med. 1995; 12: 51-55
- Density distribution of erythrocytes in class A2 (insulin requiring) gestational diabetes.Arch. Gynecol. Obstet. 1996; 258: 65-68
- Investigation of the effect of poorly controlled diabetes mellitus on erythrocyte life.J. Diabetes Complications. 1995; 9: 190-193
- Plasma and red cell folate in newborn twins and their mothers in relation to gestational age.Acta Obstet. Gynecol. Scand. 1981; 60: 379-383
- Age distribution of erythrocyte population in women with twin pregnancy.Gynecol. Obstet. Invest. 1993; 36: 163-165
- Hemoglobin levels during twin versus singleton pregnancies. Parity makes the difference.J. Reprod. Med. 1995; 40: 47-50
- Clinical gynecologic endocrinology and infertility. 4th ed. Williams and Wilkins, Baltimore, Maryland1989: 332
- The significance of density distribution of erythrocyte population in umbilical cord blood.Isr. J. Obstet. Gynecol. 1995; 6: 30-33
- Recent advances in hematology.J. Pediatr. 1966; 69: 466-479
- Shortened survival of fetal erythrocytes in the rat.Pediatr. Res. 1977; 11: 1155-1158
- Determination of erythrocyte survival in newborn infants by means of 51Cr-labelled erythrocytes.Pediatrics. 1961; 27: 354
- Serum erythropoietin in small for gestational age fetuses.Biol. Neonate. 1994; 65: 89-93
- Erythropoietin umbilical serum levels during labor in women with preeclampsia, diabetes and preterm labor.Am. J. Perinatol. 1994; 11: 427-429
- Density distribution of erythrocytes of umbilical cord erythrocytes in fetuses with antepartum death.Arch. Perinat. Med. 1997; 3: 73-76
Article info
Publication history
Accepted:
February 3,
2000
Received in revised form:
November 11,
1999
Received:
August 13,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
