Evaluation of the interferon status in pregnant women with a high risk for infection complications

Subjects and methods. One hundred patients and their newborn infants were examined. Group 1 (a study group) consisted of 65 pregnant women with urogenital infection (UGI), including 24 with preterm birth (PB) and intrauterine infection (IUI) (Subgroup 1a), 15 with PB without IUI (Subgroup 1b), and 26 with term birth (Subgroup 1c). Group 2 (a control group) comprised 20 patients without IGI in whom pregnancy resulted in term birth. Group 3 (a comparison group) included 15 non-pregnant women. Cytokine gene expression in the peripheral cell mononuclear cells was determined using reverse-transcription polymerase chain reaction. A biological method was used to determine the elaboration of interferons (IFN) and the sensitivity of peripheral blood leukocytes (PBL) to IFN preparations. A patient was considered to be susceptible to IFN-α and IFN-γ if her PBLs responded by producing the higher levels of IFN during priming with at least one of the interferons. Results. The capacity to induce IFN-α production in the cultured leukocytes of pregnant women with PB was higher than that in healthy pregnant women (35.5±11.6 U/ml versus 25.5±5.4 U/ml). That to produce IFN-γ in the pregnant women with PB was, on the contrary, diminished (5.1±2.4 U/ml and 14.9±1.6 U/ml, respectively; р < 0.05). In pregnant women who gave birth prematurely, the ratio of induced IFN-α/IFN-γ production averaged 9.7±3.2 versus 3.2±1.4 in those who gave birth at term (p < 0.05). The induced IFN-α/IFN-γ production ratio more than 5 may be a prognostic factor for PB and fetal IUI. The positive prognostic value of this factor is 69%; its negative prognostic value is 85.7%; the sensitivity and specificity are 90 and 60%, respectively. In the pregnant women with PB, the high gene expression of IFN-α (82.3%) matches with its high elaboration in the cultured leukocytes (35.5±11.6 U/ml); however, with the high gene expression of IFN-γ (91.0%), its production is lowered (5.1±2.4 U/ml), suggesting impaired IFN-γ synthesis. PBLs in pregnant women with PB of infection genesis were noted to be highly sensitive to IFN preparations: Roferon A (82.0%) and Intron A (82.0%); in this case the sensitivity of cultured leukocytes to Gammaferon was found only in 20.5% of cases (p < 0.05). Conclusion. The risk factors of PB and fetal and neonatal IUI are UGI during pregnancy concurrent with chronic inflammatory diseases of small pelvic organs or chronic extragenital diseases. In the pregnant women with PB and high gene expression levels of IFN-γ, its production is lowered in the cultured leukocytes, which suggests impaired IFN-γ production at the post-transcriptional level. The induced PBL IFN-α/IFN-γ production ratio by 5 or more times allows PB to be predicted with a high degree of accuracy. The highest susceptibility (82.0%) to IFN-α preparations (Roferon A, Intron A) is shown by the leukocytes from pregnant women in the UGI and PB group, i.e. with the most pronounced changes in the interferon status.

interferon status, pregnant women, infectious complications