ABSTRACT
Objectives: This study investigates the use of pro- and anti-inflammatory cytokines in predicting the outcome of pregnancy complicated by threatened miscarriage. Materials and Methods: Of the 140 eligible pregnant women recruited for the study, maternal serum levels of selected inflammatory cytokines (IL-2, IFNγ, IL-4, and IL-13) for 70 women with threatened miscarriage were analysed for this study. Serum concentrations were measured using the enzyme-linked immunosorbent assay (ELISA) kit. Inevitable miscarriage or ongoing pregnancy was used as the outcome, whereas serum levels of selected inflammatory cytokines, women's sociodemographic characteristics, gynaecologic history, and clinical history were used as the explanatory variables. The Student's t test was used to compare the cytokine profiles between women with inevitable miscarriages and women with normal ongoing pregnancy after 13 weeks of gestation. Poisson regression models were performed to investigate the factors associated with inevitable miscarriage. Results: The result revealed significantly higher pro-inflammatory cytokines, IL-2 (P < 0.001), and IFNγ (P < 0.001) in women with a pregnancy that resulted in an inevitable miscarriage than in those that resulted in an ongoing pregnancy. The incidence rate of inevitable miscarriage increased by 16% (IRR = 1.16, 95% CI: 0.58-2.32) for a unit increase in IL-2 and by 25% (IRR = 1.25, 95% CI: 1.09-1.43) when adjusted for sociodemographic characteristics, gynaecology, and clinical history. Conclusion: The IL-2 was the best biomarker for predicting the outcome of threatened pregnancy with a sensitivity of 80% and a specificity of 70% at 1.30 pg/mL cut-off point.
ABSTRACT
OBJECTIVE: To compare the levels of proinflammatory cytokines in women with threatened miscarriage and normal pregnancy. METHODS: This study was a longitudinal study. Consenting women with normal pregnancy and those admitted on account of threatened miscarriage at an estimated gestational age of 6-10 weeks were included in the study. The proinflammatory cytokines interleukin-2 (IL-2) and interferon-γ (IFN-γ) and the anti-inflammatory cytokines IL-4 and IL-13 were measured at the diagnosis of threatened miscarriage (baseline) and in the 13th week of pregnancy. The χ2 test of association was used to examine the relationship between the pregnancy type and demographic characteristics; clinical history and gynecologic history. Student t test was used to compare the selected cytokine between women with threatened miscarriage and normal pregnancy. RESULTS: There was a significantly higher IL-2 (P = 0.033), IFN-γ (P < 0.001), and IL-13 (P < 0.001) in women with threatened miscarriage than in women with normal pregnancy at the baseline. At the follow up, the results revealed a significantly higher IFN-γ level (P < 0.001) and IL-4 (P = 0.019) in women with threatened miscarriage than in women with normal pregnancies. CONCLUSION: Proinflammatory cytokine profiles were associated with a higher risk of threatened miscarriage.
