Departments of Obstetrics and Gynecology, Wake Forest University Health Sciences, Winston-Salem, North Carolina, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Wayne State University, Detroit, Michigan, University of Utah Health Sciences Center, Salt Lake City, Utah, Columbia University, New York, New York, University of Pittsburgh, Pittsburgh, Pennsylvania, The Ohio State University, Columbus, Ohio, Women and Infants Hospital, Brown University, Providence, Rhode Island, Northwestern University, Chicago, Illinois, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio, Drexel University College of Medicine, Philadelphia, Pennsylvania, the University of Alabama at Birmingham, Birmingham, Alabama, the University of Texas Health Science Center at Houston, Houston, Texas, and the University of Texas Medical Branch, Galveston, Texas; the Division of Inflammation Biology and Immunology, Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, Virginia; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Obstet Gynecol. 2013 Apr;121(4):805-811. doi: 10.1097/AOG.0b013e3182878a80.
To estimate the associations of change in immune response with preterm delivery, omega-3 supplementation, and fish diet.
This was an ancillary study to a randomized trial of omega-3 fatty acid supplementation for the prevention of recurrent preterm birth. In vitro maternal peripheral blood mononuclear leukocyte production of the anti-inflammatory cytokine, interleukin-10, and the proinflammatory cytokine, tumor necrosis factor-α, in response to stimulation with lipopolysaccharide, was measured at 16-22 weeks of gestation (baseline) and again at 25-28 weeks of gestation (follow-up) among women with prior spontaneous preterm birth. Changes in concentrations from baseline to follow-up ([INCREMENT]) were compared separately among groups defined by gestational age category at delivery, fish diet history, and omega-3 compared with placebo treatment assignment with Kruskal-Wallis tests.
Interleukin-10 [INCREMENT] differed by gestational age category among 292 women with paired assays. Concentrations increased less in women delivering between 35 and 36 6/7 weeks of gestation (48.9 pg/mL) compared with women delivering at term (159.3 pg/mL) and decreased by 65.2 pg/mL in women delivering before 35 weeks of gestation (P=.01). Tumor necrosis factor-α Δ also differed by gestational age category among 319 women, but the pattern was inconsistent. Those delivering between 35 and 36 6/7 weeks of gestation exhibited decreased concentrations of tumor necrosis factor-α at follow-up compared with baseline (-356.0 pg/mL); concentrations increased among women delivering before 35 weeks of gestation and those delivering at term, 132.1 and 86.9 pg/mL (P=.03). Interleukin-10 Δ and tumor necrosis factor-α Δ were unaffected by either omega-3 supplementation or fish diet.
Recurrent preterm birth was associated with decreased peripheral blood mononuclear leukocyte production of interleukin-10 in response to a stimulus during the second trimester.
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00135902.
II.
评估免疫反应变化与早产、ω-3 补充剂和鱼类饮食的关联。
这是一项针对ω-3 脂肪酸补充剂预防复发性早产的随机试验的辅助研究。在有自发性早产史的女性中，于妊娠 16-22 周（基线）和 25-28 周（随访）时，测量体外母体外周血单个核细胞对脂多糖刺激后抗炎细胞因子白细胞介素-10 和促炎细胞因子肿瘤坏死因子-α的产生。比较不同分娩时孕周类别、鱼类饮食史和 ω-3 与安慰剂治疗分配的组之间从基线到随访的浓度变化（增量），采用 Kruskal-Wallis 检验。
在 292 名具有配对检测的女性中，白细胞介素-10 [增量] 因分娩时的孕周类别而异。在 35 至 36 6/7 周分娩的女性中，浓度增加较少（48.9 pg/mL），与足月分娩的女性（159.3 pg/mL）相比，而在 35 周前分娩的女性中减少了 65.2 pg/mL（P=.01）。在 319 名女性中，肿瘤坏死因子-αΔ也因分娩时的孕周类别而异，但模式不一致。在 35 至 36 6/7 周分娩的女性中，与基线相比，随访时肿瘤坏死因子-α的浓度降低（-356.0 pg/mL）；在 35 周前分娩和足月分娩的女性中，浓度增加，分别为 132.1 和 86.9 pg/mL（P=.03）。白细胞介素-10Δ和肿瘤坏死因子-αΔ不受 ω-3 补充或鱼类饮食的影响。
复发性早产与妊娠中期刺激后外周血单个核细胞白细胞介素-10 的产生减少有关。
ClinicalTrials.gov，www.clinicaltrials.gov，NCT00135902。
II 级。
