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  • Title: First-trimester maternal plasma cytokine levels, pre-pregnancy body mass index, and spontaneous preterm delivery.
    Author: Curry AE, Thorsen P, Drews C, Schendel D, Skogstrand K, Flanders WD, Hougaard D, Olsen J, Vogel I.
    Journal: Acta Obstet Gynecol Scand; 2009; 88(3):332-42. PubMed ID: 19241227.
    Abstract:
    OBJECTIVE: To examine associations between first-trimester plasma cytokines and spontaneous preterm delivery (sPTD). DESIGN: A case-control study was nested within the Danish National Birth Cohort, a cohort of women with 101,042 pregnancies from 1997 to 2002 who were recruited during pregnancy and followed prospectively. SAMPLE: Subjects included 107 women delivering singleton infants at 24-29 weeks, 353 at 30-33 weeks, 422 at 34-36 weeks, and 1,372 at > or =37 weeks. METHODS: Maternal plasma interleukin (IL)-2, IL-6, tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, and granulocyte-macrophage colony-stimulating factor (GM-CSF) were measured at a median of eight weeks gestation using multiplex flow cytometry. Adjusted odds ratios (ORs) were obtained using polytomous logistic regression. MAIN OUTCOME MEASURES: sPTD categorized as: 24-29 weeks, 30-33 weeks, 34-36 weeks, and > or =37 weeks (controls). RESULTS: Elevated TNF-alpha and GM-CSF were associated with an increased risk of delivery at 34-36 weeks. In underweight women, sPTD <34 weeks was associated with elevated (>75th percentile) IL-6 (OR=5.62, 95% confidence interval (CI): 1.73, 18.26) and TNF-alpha (OR=3.02, CI: 1.02, 8.91) compared with term delivery. Conversely, among obese women, elevated IL-2 (OR=0.30, CI: 0.11, 0.78) and TNF-alpha (OR=0.15, CI: 0.05, 0.47) were associated with a reduced risk of delivering at <34 weeks. Cytokines were not related to delivery at <34 weeks in normal-weight and overweight women. CONCLUSIONS: These findings suggest that the association between first-trimester plasma cytokine levels and sPTD may depend on pre-pregnancy body mass index.
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