Open AccessFirst‐trimester maternal plasma cytokine levels, pre‐pregnancy body mass index, and spontaneous preterm delivery
Author(s) -
CURRY ALLISON ELIZABETH,
THORSEN POUL,
DREWS CAROLYN,
SCHENDEL DIANA,
SKOGSTRAND KRISTIN,
FLANDERS WILLIAM DANA,
HOUGAARD DAVID,
OLSEN JØRN,
VOGEL IDA
Publication year - 2009
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340802702219
Subject(s) - medicine , odds ratio , pregnancy , body mass index , underweight , gestation , confidence interval , obstetrics , gestational age , prospective cohort study , risk factor , overweight , gynecology , genetics , biology
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 ≥37 weeks. Methods . Maternal plasma interleukin (IL)‐2, IL‐6, tumor necrosis factor (TNF)‐α, interferon (IFN)‐γ, 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 ≥37 weeks (controls). Results . Elevated TNF‐α 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‐α (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‐α (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.