Tumor necrosis factor-alpha and pregnancy complications: a prospective study

ABSTRACT

The aim of this study was to compare the levels of tumor necrosis factor-alpha [TNF-alpha] produced by peripheral blood mononuclear cells in normal pregnancies and pregnancies with complications. Materials and Maternal peripheral blood mononuclear cells from women with a recurrent spontaneous miscarriage [n = 35], premature rupture of fetal membranes [n = 30], preeclampsia [n = 27] and intrauterine fetal growth retardation [IUGR; n = 36] were stimulated with mitogen or antigen, and the levels of TNF-alpha produced were compared to those produced by peripheral blood mononuclear cells from a normal pregnancy [n = 35]. The median levels of mitogen-induced TNF-alpha at the 1st, 2nd and 3rd trimester, and at normal delivery were 1,176.4, 4,320.9, 7,307.4 and 2,463.0 pg/ml, respectively, while those produced in the recurrent spontaneous miscarriage, premature rupture of membranes and preeclampsia cases were 4,159.8, 3,489.5 and 4,149.2 pg/ml, respectively. The differences were statistically significantly higher in these pregnancy complications [p = 0.04, 0.024 and 0.014] as compared to the levels in normal pregnancy. Furthermore, antigen-induced TNF-alpha levels were produced at statistically significantly higher levels by women with IUGR [120.4 pg/ml] compared to women with normal pregnancies [17.9 pg/ml; p = 0.041]. Higher levels of TNF-alpha seem to play a role in these pregnancy complications, suggesting its pathogenesis in such conditions