Proinflammatory cytokines are markers of fetal growth retardation

Abstract

Objective: To investigate the immune interrelationships between mother and fetus in chronic placental failure which leads to intrauterine fetal growth retardation (IUGR).

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Methods: In order to study the immune mechanisms of IUGR pathogenesis, we examined the levels of proinflammatory cytokines such as interleukin-l-alpha (IL-la), interleukin-l-beta (IL-lb), interleukin-8 (IL-8) and tumor necrosis alpha factor (TNF-a) in maternal blood and in amniotic fluid. Cytokines were tested by double-antibody enzyme immunoassay. Amniotic fluid was obtained by amniocentesis before cesarean section or induced labor.

Results: The study was performed on 10 pregnants with preeclampsia, on 10 women with preeclampsia combined TUGR and on 10 females with uncomplicated pregnancy (control group) in 28-38 weeks of gestation period. The blood levels of IL-la, IL-8 and TNF-a in patients with preeclampsia were more elevated than in healthy pregnant women. In pregnants with IUGR the blood levels of IL-lb, IL-8 and TNF-a were elevated more considerably than in women with preeclampsia without IUGR. Fetal funic blood from mothers with IUGR was characterized by higher levels of inflammatory cytokines (especially TNF-a and IL-lb) than those in fetuses of other groups. Women with IUGR had the most elevated amniotic fluid levels of IL-lb, IL-8 and TNF-a than women with normal pregnancy and pregnants with preeclampsia. High levels of inflammatory cytokines led to the intensification of hypercoagulation, decreased levels of antithrombin Illand protein C, plasminogen consumption, increased levels of Fibrin degradation products.

Conclusions: These results suggest that the levels of proinflammatory cytokines can serve as diagnostic criteria for IUGR. Cardinal signs of IUGR are elevated levels of TL-la and TNF-a in maternal blood and IL-lb, IL-8 in amniotic fluid.