Oztas Efser, Erkenekli Kudret, Ozler Sibel, Aktas Aynur, Buyukkagnıcı Umran, Uygur Dilek, Danisman Nuri
Departments of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
Department of Endocrinology and Metabolism, Ankara Education and Research Hospital, Ankara, Turkey.
J Obstet Gynaecol Res. 2015 Nov;41(11):1700-7. doi: 10.1111/jog.12799. Epub 2015 Aug 26.
The aim of the present study is to compare pregnancy outcomes among patients with and without thyroid antibodies and/or subclinical hypothyroidism and investigate whether there is an association between first trimester maternal plasma interleukin-6 (IL-6) levels and adverse pregnancy outcomes.
A case-control study was carried out including 83 pregnant women (40 thyroid antibody positive and 43 healthy controls). The predictive value of first trimester maternal plasma IL-6 levels on adverse pregnancy outcomes were investigated. The optimal cut-off points of IL-6 for determining maternal and fetal outcomes were evaluated by receiver operating characteristic analyses.
Compared with the control, median IL-6 levels were significantly higher in thyroid antibody positive pregnancies (median 1.58 vs 1.63 pg/mL; P = 0.047). IL-6 levels were found to be significantly higher in women who had suffered a miscarriage (P = 0.002), preterm delivery (P < 0.001), intrauterine growth restriction (P = 0.047), preterm premature rupture of membranes (P = 0.043) and overall prenatal complications (P < 0.001). A statistically significant negative correlation between gestational week at birth and IL-6 levels was also determined among all participants involved in the study (r = -0.385, P < 0.001).
IL-6 levels are significantly increased in thyroid antibody positive patients and predictive for future adverse outcomes, irrespective of thyroid autoimmunity. Increased first trimester IL-6 levels independently predict adverse pregnancy outcomes, regardless of subclinical hypothyroidism.
本研究旨在比较有和没有甲状腺抗体和/或亚临床甲状腺功能减退症患者的妊娠结局，并调查孕早期母体血浆白细胞介素-6（IL-6）水平与不良妊娠结局之间是否存在关联。
进行了一项病例对照研究，纳入83名孕妇（40名甲状腺抗体阳性和43名健康对照）。研究了孕早期母体血浆IL-6水平对不良妊娠结局的预测价值。通过受试者工作特征分析评估用于确定母婴结局的IL-6最佳截断点。
与对照组相比，甲状腺抗体阳性妊娠的IL-6中位数水平显著更高（中位数1.58对1.63 pg/mL；P = 0.047）。发现流产（P = 0.002）、早产（P < 0.001）、胎儿生长受限（P = 0.047）、胎膜早破（P = 0.043）和总体产前并发症（P < 0.001）的女性IL-6水平显著更高。在参与研究的所有参与者中，出生孕周与IL-6水平之间也确定存在统计学显著的负相关（r = -0.385，P < 0.001）。
甲状腺抗体阳性患者的IL-6水平显著升高，且可预测未来不良结局，与甲状腺自身免疫无关。孕早期IL-6水平升高独立预测不良妊娠结局，与亚临床甲状腺功能减退无关。
