Erythrocyte Sedimentation Rate (ESR) — Pregnancy Reference Values

Perinatology.com › Reference › Hematology › ESR

ESR (whole blood)

Units Nonpregnant Female 1st Trimester 2nd Trimester 3rd Trimester
mm/hour 0 – 20 4 – 57 7 – 47 13 – 70
Physiology in Pregnancy
  • ESR normally increases during pregnancy.
  • Rise is largely due to increased fibrinogen and inflammatory proteins.
  • Anemia of pregnancy also increases ESR.
  • Because ESR rises physiologically, it is not reliable for diagnosing infection in pregnancy.
Causes of Elevated ESR
  • Normal pregnancy (physiologic elevation)
  • Anemia (iron deficiency, hemodilution)
  • Acute or chronic inflammation
  • Autoimmune disease (RA, lupus)
  • Infection
  • Malignancy
  • Renal disease
  • Hypergammaglobulinemia
Causes of Low ESR
  • Polycythemia
  • Extremely high leukocyte count
  • Sickle cell disease
  • Severe hypofibrinogenemia

References

  1. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114:1326–1331. PMID: 19935037.