Argentine Society of Pediatrics Buenos Aires Argentina Argentine Society of Pediatrics, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Faculty of Medicine of Ribeirão Preto Universidade de São Paulo Ribeirão PretoSP Brazil Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Rev Bras Ginecol Obstet. 2024 Jul 26;46. doi: 10.61622/rbgo/2024rbgo58. eCollection 2024.
To assess a panel of cytokines and placental insufficiency with the risk of preterm delivery (PTD).
Nested case-control study into the BRISA birth cohort. Eighty-two mother-infant-placenta pairs were selected at 20 to 25 weeks. Circulating biomarker levels were performed using Luminex flowmetric xMAP technology. Cytokines classified as Th1, Th2 or Th17 and other biomarkers were selected. The ratio between birth weight and placental weight (BW/PW) was used as a proxy for placental efficiency. Spearman correlation, univariate analyses and logistic regression models were calculated. Sensitivity, specificity, positive and negative likelihood ratios were calculated using the Receiver Operating Characteristic curve.
Mean gestational age was 250 days, 14,6% were small for gestational age, 4,8% large for gestational age and 13,4% stunted. Placental efficiency was higher for term newborns (p<0,001), and 18/22 (81%) preterm biomarker values were higher than the control group. Th1 cytokines were highly correlated, while the weakest correlation was observed in other biomarkers. Less education was associated with a higher risk of PTD (p = 0.046), while there was no appreciable difference in the risk of PTD for placental insufficiency. Biomarkers showed negligible adjusted OR of PTD (0.90 to 1.02). IL-6, IL-8, IL-1β, TNFβ, IL-4, IL-13, GCSF, MIP1A, VEGF, EGF, and FGF2 presented a higher sensitivity ranging from 75.56% to 91.11%.
IL-8, IL-12p40, IL-4, IL-13, GCSF, MIP1B, and GMSF in asymptomatic pregnant women were associated with PTD. This finding suggests an activation of maternal inflammatory response.
评估细胞因子与胎盘功能不全对早产（PTD）的风险。
BRISA 出生队列的巢式病例对照研究。在 20-25 周时选择了 82 对母婴胎盘。使用 Luminex 流式细胞术 xMAP 技术进行循环生物标志物水平检测。选择了 Th1、Th2 或 Th17 细胞因子和其他生物标志物。体重与胎盘重量的比值（BW/PW）被用作胎盘效率的替代指标。计算 Spearman 相关、单变量分析和逻辑回归模型。使用接收者操作特征曲线计算灵敏度、特异性、阳性和阴性似然比。
平均孕龄为 250 天，14.6%为小于胎龄儿，4.8%为大于胎龄儿，13.4%为生长受限儿。足月新生儿的胎盘效率更高（p<0.001），22 例早产（81%）生物标志物值高于对照组。Th1 细胞因子相关性高，而其他生物标志物相关性最弱。受教育程度较低与早产风险增加相关（p = 0.046），而胎盘功能不全的早产风险无明显差异。生物标志物显示 PTD 的调整后比值比（OR）为 0.90 至 1.02。IL-6、IL-8、IL-1β、TNFβ、IL-4、IL-13、GCSF、MIP1A、VEGF、EGF 和 FGF2 的灵敏度较高，范围为 75.56%至 91.11%。
无症状孕妇的 IL-8、IL-12p40、IL-4、IL-13、GCSF、MIP1B 和 GMSF 与 PTD 相关。这一发现表明母体炎症反应的激活。
