Maternal Serum Cytokine Concentrations in Healthy Pregnancy and Preeclampsia

Spence, Toni; Allsopp, Philip J.; Yeates, Alison J.; Mulhern, Maria S.; Strain, Sean; McSorley, Emeir M.

doi:10.1155/2021/6649608

Cited by 54 publications

(47 citation statements)

References 175 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The continuous time analysis captured within-trimester variations that may be missed when samples are pooled in trimesters; these continuous trajectories revealed a u-shaped development for several cytokines, including IL-6. The literature is conflicting and reports both decreasing, increasing and stable IL-6 concentrations throughout pregnancy ( 14 ), probably due to methodic choices that did not capture the diverse non-linear regulation of IL-6 shown here. Future studies should take the rapid dynamics of pregnancy into account, especially towards the end of gestation.…”

Section: Discussionmentioning

confidence: 89%

“…However, the coordinated development of serum cytokines throughout normal pregnancies has not been adequately described. Earlier attempts have shown strong impact of pregnancy on serum cytokine levels but resulted in conflicting conclusions, as reviewed by Spence et al (14). While analysis of few or single cytokines has dominated the literature (14), broad cytokine profiling in pregnancy is feasible (4,13,(15)(16)(17)(18)(19)(20)(21) but these studies have typically employed small study samples or examined only parts of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…( 14 ). While analysis of few or single cytokines has dominated the literature ( 14 ), broad cytokine profiling in pregnancy is feasible ( 4 , 13 , 15 – 21 ) but these studies have typically employed small study samples or examined only parts of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cytokine Patterns in Maternal Serum From First Trimester to Term and Beyond

et al. 2021

View full text Add to dashboard Cite

Pregnancy implies delicate immunological balance between two individuals, with constant changes and adaptions in response to maternal capacity and fetal demands. We performed cytokine profiling of 1149 longitudinal serum samples from 707 pregnant women to map immunological changes from first trimester to term and beyond. The serum levels of 22 cytokines and C-reactive protein (CRP) followed diverse but characteristic trajectories throughout pregnancy, consistent with staged immunological adaptions. Eotaxin showed a particularly robust decrease throughout pregnancy. A strong surge in cytokine levels developed when pregnancies progressed beyond term and the increase was amplified as labor approached. Maternal obesity, smoking and pregnancies with large fetuses showed sustained increase in distinct cytokines throughout pregnancy. Multiparous women had increased cytokine levels in the first trimester compared to nulliparous women with higher cytokine levels in the third trimester. Fetal sex affected first trimester cytokine levels with increased levels in pregnancies with a female fetus. These findings unravel important immunological dynamics of pregnancy, demonstrate how both maternal and fetal factors influence maternal systemic cytokines, and serve as a comprehensive reference for cytokine profiles in normal pregnancies.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cytokine Patterns in Maternal Serum From First Trimester to Term and Beyond

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, it is not clear if the increased risk of HDP is a consequence of COVID-19 infection or if these patients are predisposed to both conditions. A higher cytokine levels that are seen with both HDP 20 and COVID-19 21 , as well as different susceptibility to both conditions with angiotensin converting enzyme 2 polymorphism, might be in favor of the latter.…”

Section: Discussionmentioning

confidence: 98%

Increased Risk of Severe COVID-19 Disease in Pregnancy in a Multicenter Propensity Score-Matched Study

Cojocaru

Noe

Pahlavan

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Respiratory infections have long been associated with higher maternal and perinatal morbidity. Early data did not report an increased risk of SARS-CoV-2 infection or disease severity in pregnancy. However, surveillance data from the Center for Disease Control and Prevention (CDC) indicates a higher risk of severe disease and death in pregnant women with symptomatic SARS-CoV-2 infection, although this data is subject to ascertainment bias. Objective: To explore the association between COVID-19 disease severity and pregnancy in our university-based hospital system using measures such as COVID-19 ordinal scale severity score, hospitalization, intensive care unit admission, oxygen supplementation, invasive mechanical ventilation, and death. Study design: We conducted a retrospective, multicenter case-control study to understand the association between COVID-19 disease severity and pregnancy. We reviewed consecutive charts of adult females, ages 18-45, with laboratory-confirmed SARS-CoV-2 infection in six months between March 1, 2020, and August 31, 2020. Cases were patients diagnosed with COVID-19 during pregnancy, whereas controls were not pregnant at the time of COVID-19 diagnosis. Primary endpoints were the COVID-19 severity score at presentation (within four hours) and the nadir of the clinical course. The secondary endpoints were the proportion of patients requiring hospitalization, intensive care unit admission, oxygen supplementation, invasive mechanical ventilation, and death. Results: A higher proportion of pregnant women had moderate to severe COVID-19 disease at the nadir of the clinical course than nonpregnant women (25% vs. 16.1%, p=0.04, respectively). While there was a higher rate of hospitalization (25.6% vs. 17.2%), ICU admission (8.9% vs. 4.4%), need for vasoactive substances (5.0% vs. 2.8%), and invasive mechanical ventilation (5.6% vs. 2.8%) in the pregnant group, this difference was not significant after the propensity score matching was applied. We found a high rate of pregnancy complications in our population (40.7%). The most worrisome is the rate of hypertensive disorders of pregnancy (20.1%). Conclusions: In our propensity score-matched study, COVID-19 in pregnancy is associated with an increased risk of disease severity and an increased risk of pregnancy complications.

show abstract

“…Preeclampsia occurs in 2-8% of pregnancies and is associated with systemic maternal inflammation and consistently elevated serum levels of classical proinflammatory cytokines including TNF-a, IFN-g, IL-2, IL-6 and IL-8 (11,12). While the underlying pathogenesis of preeclampsia remains undefined, fractured fetal tolerance is likely an important causative factor since the only effective treatment in affected women is delivery of the fetus and all products of conception (13).…”

Section: Parity and Immune Tolerance Memory In Preeclampsia And Other Pregnancy Complicationsmentioning

confidence: 99%

Epidemiology of Pregnancy Complications Through the Lens of Immunological Memory

et al. 2021

View full text Add to dashboard Cite

In the fifteen minutes it takes to read this short commentary, more than 400 babies will have been born too early, another 300 expecting mothers will develop preeclampsia, and 75 unborn third trimester fetuses will have died in utero (stillbirth). Given the lack of meaningful progress in understanding the physiological changes that occur to allow a healthy, full term pregnancy, it is perhaps not surprising that effective therapies against these great obstetrical syndromes that include prematurity, preeclampsia, and stillbirth remain elusive. Meanwhile, pregnancy complications remain the leading cause of infant and childhood mortality under age five. Does it have to be this way? What more can we collectively, as a biomedical community, or individually, as clinicians who care for women and newborn babies at high risk for pregnancy complications, do to protect individuals in these extremely vulnerable developmental windows? The problem of pregnancy complications and neonatal mortality is extraordinarily complex, with multiple unique, but complementary perspectives from scientific, epidemiological and public health viewpoints. Herein, we discuss the epidemiology of pregnancy complications, focusing on how the outcome of prior pregnancy impacts the risk of complication in the next pregnancy — and how the fundamental immunological principle of memory may promote this adaptive response.

show abstract

Maternal Serum Cytokine Concentrations in Healthy Pregnancy and Preeclampsia

Cited by 54 publications

References 175 publications

Cytokine Patterns in Maternal Serum From First Trimester to Term and Beyond

Cytokine Patterns in Maternal Serum From First Trimester to Term and Beyond

Increased Risk of Severe COVID-19 Disease in Pregnancy in a Multicenter Propensity Score-Matched Study

Epidemiology of Pregnancy Complications Through the Lens of Immunological Memory

Contact Info

Product

Resources

About