Maternal serum cytokine levels in pregnancies complicated with threatened preterm labour

Abstract

Objective: To investigate serum inflammatory markers in singleton gestations complicated with threatened preterm labour (TPL).

Methods: Pregnant women complicated with TPL (n = 61) were recruited to measure maternal serum levels of a panel of cytokines and C-reactive protein and then compared to controls without TPL, matched for gestational age (n = 64) and term pregnancies in the prodromal phase of labour (PPL) (n = 31). In addition, baseline cytokine levels were compared among cases and controls according to the outcome.

Results: Women with TPL displayed higher CRP and white blood counts levels together with lower granulocyte macrophage colony-stimulating factor (GMC-SF) compared to both controls without TPL and to term gestations in the PPL. Also, interleukin 10 (IL-10), IL-6, IL-7, IL-8 and tumour necrosis alpha (TNF-α) levels were found significantly higher in TPL cases as compared to controls without TPL and term women in the PLL. Baseline cytokine levels (except IL-10) were higher among TPL cases who later delivered preterm. TPL cases delivering preterm displayed lower GMC-SF levels as compared to those delivering at term. Multivariate analysis found that gestational age at birth positively correlated with cervical length and inversely with CRP, IL-6 and TNF-α levels (p < 0.0001).

Conclusions: TPL and preterm birth were related to inflammatory changes in the maternal side that correlate with cervical shortening and the initiation of uterine contractions.

Chinese abstract

目的: 研究单胎妊娠合并先兆早产 (TPL) 的血清炎症标志物。

方法: 入组61例妊娠合并TPL的患者, 测量一组母体血清细胞因子和C反应蛋白 (CRP) 水平, 然后与无TPL的相应胎龄的患者 (n = 64) 及处于分娩前驱期 (PPL) 的足月妊娠者 (n = 31) 相比。此外, 根据结果, 比较病例和对照之间的基线细胞因子水平。

结果: 与没有TPL的患者及处于PPL的足月妊娠者相比, TPL患者显示较高水平的CRP和白细胞计数以及较低水平的粒细胞巨噬细胞集落刺激因子 (GMC-SF), 且其体内的白细胞介素10 (IL-10) 、白细胞介素6 (IL-6) 、白细胞介素7 (IL-7) 、白细胞介素8 (IL-8) 和肿瘤坏死因子 (TNF-α) 水平显著升高。早产结局的TPL患者体内的基线细胞因子水平 (IL-10除外) 更高。与足月分娩的TPL患者相比, 早产结局的TPL患者显示更低水平的的GMC-SF。多变量分析发现, 出生胎龄与宫颈长度呈正相关, 与CRP, IL-6和TNF-α水平呈负相关 (p <0.0001) 。

结论: TPL和早产与宫颈缩短和子宫收缩引起的母体炎症反应相关。

Keywords:

• Cytokine
• inflammation
• preterm birth
• threatened preterm labour

Declaration of interest

The authors declare having no conflicts of interest.

This study was supported by the grant PI-0487/2011 of the “Fundación Pública Andaluza Progreso y Salud” for Financiation of Biomedical Research in Health Sciences in Andalucía (Spain) to study hormone factors in preterm labour.