Erythropoietin (EPO) — Pregnancy Reference Values

Perinatology.com › Reference › Hematology › EPO

Erythropoietin (serum)

Units Nonpregnant Adult 1st Trimester 2nd Trimester 3rd Trimester
U/L 4 – 27 12 – 25 8 – 67 14 – 222
Physiology in Pregnancy
  • Erythropoietin (EPO) levels increase during pregnancy.
  • Rise is driven by increased red cell mass needs, plasma volume expansion, and mild physiologic anemia.
  • Placentally derived factors may enhance EPO production.
  • EPO peaks in the third trimester.
Causes of Elevated EPO
  • Normal pregnancy
  • Anemia (iron deficiency, hemoglobinopathies, acute/chronic blood loss)
  • Chronic hypoxia (e.g., congenital heart disease, chronic lung disease)
  • High-altitude exposure
  • Renal disease with increased EPO production
  • EPO-secreting tumors (rare)
Causes of Low EPO
  • Chronic kidney disease (reduced renal EPO production)
  • Anemia of chronic disease / inflammation
  • Bone marrow suppression
  • Polycythemia vera (feedback suppression)

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.