Abstract:
Background: Abnormalities of blood cell counts and of cytokine profiles in women with hypertensive disorders of
pregnancy (HDP) have been reported in several studies. Although their cause-effect relationships to HDP are not
yet clear, detecting and monitoring these alterations can be of use for prognosis and management of HDP. This
study aimed to determine hematological, coagulation and cytokine profiles in hypertensive as compared to
normotensive pregnancy and to identify correlations between these profiles.
Methods: This was a hospital-based comparative cross-sectional study conducted from September 2017 to
February 2018. There were two groups: the comparison group consisted of 77 normotensive pregnant women
attending the antenatal clinic of Muhimbili National Hospital (MNH); the index group consisted of 76 hypertensive
pregnant women admitted to the maternity block of the same hospital. Hematological and cytokine parameters
were compared between the hypertensive and the normotensive group. We analyzed the data using Student’s
independent t-test when the data were normally distributed; and the Mann–Whitney U-test when the data were
not normally distributed. Kruskal Wallis with Dunn’s multiple comparison tests was run for subgroup analysis and
correlation studies were done using Spearman ranking.
Results: Hemoglobin levels were slightly but significantly lower, (P < 0.01) in women with HDP compared to
normotensive (N) women; the same was true for platelet counts (P < 0.001). The red cell distribution width (RDW)
was slightly but significantly higher in HDP than in N. Neutrophil counts and Interleukin 6 (IL-6) levels were
significantly (P < 0.001) higher in HDP than in N; and within HDP IL-6 levels increased with increasing severity of
HDP. A novel remarkable finding was that eosinophil counts, normal in N, were lower and lower with increasing
severity of HDP, to the point that they were nearly absent in women with eclampsia.
Conclusion: There are significant changes in hematological, cytokine and coagulation parameters in pregnant
women with hypertensive disorders compared to normotensive pregnant women. The picture that emerges is that
of an inflammatory state associated with hypertensive disorders of pregnancy.
