Objective: To examine changes in lymphocyte subpopulations in early pr
egnancy using a methodologically appropriate study design that address
es previous sources of bias. Methods: Thirty-seven healthy women witho
ut risk factors for human immunodeficiency virus (HIV) were reviewed w
hen less than 9 weeks pregnant (median 51 days, range 44-61) and again
at least 4 weeks following termination of pregnancy. No woman took th
e oral contraceptive pill. Blood was taken on each occasion at the sam
e time of day under the same conditions of rest and food intake, trans
ported immediately to the laboratory, and directly prepared for analys
is. Lymphocyte surface markers were determined by staining with dual-c
olored, isotype-matched monoclonal antibody fluorescent conjugates, fo
llowed by whole blood lysis and subsequent flow cytometric analysis. R
esults: Pregnancy was associated with a significant reduction in total
lymphocytes (P<.0001) and also in CD4+ cells, whether expressed as a
percentage of lymphocytes (P=.004, an absolute count (P=.0006), or a r
atio (P=.01). Change was independent of the basal level except for lym
phocytes, and almost all indices had significant correlations between
pregnant and nonpregnant values. Conclusions: In this study design, ea
ch woman served as her own control and all factors remained constant e
xcept the pregnancy state. Early pregnancy causes a reduction in total
lymphocytes of about 6% expressed as a percentage of total white cell
count, and in CD4+ cells by 3% as a percentage of lymphocytes, or 100
/mm(3). We believe this fall can be accepted as definitive.