The Role of Cytokines in the Development of Early Pregnancy Loss in Women with a History of Metabolic Disorders

I. V. Zhukоvets, O. Leshchenko, I. Andrievskaya, K. K. Petrova
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Abstract

Background. Spontaneous miscarriage is the most common complication of pregnancy. Obesity increases the risk of adverse pregnancy outcomes. Aim of the study. To assess the cytokine profile as a marker of spontaneous miscarriage in women with metabolic disorders in the past medical history. Materials and methods. A prospective study of 170 adolescent girls with metabolic disorders was conducted between 2000 and 2013. Assessment of menstrual and reproductive function was carried out in 86, pregnancy outcomes – in 72 women. The average age of women in reproductive age was 21.95 ± 0.2 years, BMI – 24.7 ± 3.9 kg/m2. Results. In women with early pregnancy losses and metabolic disorders in past medical history, the predictor of an early pregnancy loss is an increase in the ratio of pro- and anti-inflammatory cytokines TNF-a/IL-10 in serum at 7–8 weeks of gestation (OR = 2.29). It was determined a significant correlation between the levels of pro- and anti-inflammatory cytokines of the same name in serum and chorion (IL-10 (p = 0.000) and TNF-α/IL-10 (p = 0.001), which indicates similar changes in chorion. The activity of NF-kB in chorion was 5.75 ± 0.51 pg/ml. Conclusions. The findings suggest that the cytokine balance of pro- and anti-inflammatory cytokines in women with metabolic disorders in past medical history is an important component in the development of early pregnancy losses.
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细胞因子在有代谢障碍史的妇女早期妊娠丢失中的作用
背景。自然流产是妊娠最常见的并发症。肥胖会增加不良妊娠结局的风险。研究的目的。评估细胞因子谱作为既往病史中有代谢紊乱的妇女自发性流产的标志物。材料和方法。在2000年至2013年期间,对170名患有代谢紊乱的青春期女孩进行了一项前瞻性研究。对72名妇女的86例妊娠结局进行了月经和生殖功能评估。育龄妇女平均年龄21.95±0.2岁,BMI - 24.7±3.9 kg/m2。结果。在既往病史中有早孕丢失和代谢紊乱的妇女中,早孕丢失的预测因子是妊娠7-8周时血清中促炎性和抗炎性细胞因子TNF-a/IL-10比值的增加(OR = 2.29)。血清和绒毛膜中同名促炎因子和抗炎因子(IL-10 (p = 0.000)和TNF-α/IL-10 (p = 0.001)水平之间存在显著相关性,表明绒毛膜的变化相似。绒毛膜中NF-kB活性为5.75±0.51 pg/ml。结论。研究结果表明,既往有代谢障碍的妇女的促炎性和抗炎性细胞因子平衡是早期妊娠丢失的重要组成部分。
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