Maternal proinflammatory cytokines and risk of stillbirth in women with pregnancy induced hypertensive disorders

Abstract

OBJECTIVES: Stillbirth, often a consequence of pregnancies complicated by disorders such as gestational hypertension, is a condition insufficiently addressed in resource-limited countries. Developing new methods for early detection and management of gestational hypertension can help reduce stillbirths and associated adverse pregnancy outcomes by enabling timely interventions for high-risk pregnancies. As cytokines are implicated in hypertension, we proposed to evaluate the association of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) with stillbirths among women affected by pregnancy-induced hypertensive disorders.

METHODS: Our case-control study constituted a total of 150 pre-delivery samples: 50 of them from women who experienced stillbirths were taken as cases, 50 from women who had preterm livebirths were taken as preterm controls, and 50 from those who had a term livebirth were taken as term controls. These samples were selected through computer-generated random selection from the overall population. The cytokine profile in maternal serum was measured using sandwich ELISA.

RESULTS: The TNF-α findings revealed statistically significant differences between the stillbirths (median [Q1, Q3]: 349 [168, 415]), preterm livebirths (median [Q1, Q3]: 223 [120, 384]), and term livebirths (median [Q1, Q3]: 221 [100, 311]) (P = 0.02). Conversely, results obtained for IL-6 demonstrated statistically significant differences between the stillbirths (median [Q1, Q3]: 117 [20, 220]) and preterm controls (median [Q1, Q3]: 22 [17, 63]) (P = 0.001). However, no statistically significant difference was observed between the stillbirths and the term controls (median [Q1, Q3]: 63 [28, 127]).

CONCLUSION: Tumor necrosis factor alpha was found to be strongly associated with risk of stillbirth, whereas IL-6 showed a moderate association.