Serum levels of adrenomedullin and inflammatory cytokines in women with term idiopathic intrauterine growth restriction

This study aimed to determine the concentrations of adrenomedullin (AM), tumour necrosis factor (TNF)-alpha and interleukin (IL)-6 in maternal circulation of full-term idiopathic intrauterine growth restriction (IUGR) in relation to appropriate-for-gestational-age (AGA) and the possible correlation of AM to these cytokines. A case-control study included 50 idiopathic IUGR mothers and 25 AGA, who were evaluated regarding their serum levels of AM, TNF-alpha and IL-6. We found that women with idiopathic IUGR have significantly higher serum levels of AM, TNF-alpha and IL-6 (p = 0.008; 0.016; 0.029, respectively) and the level of AM was significantly correlated to serum level of TNF-alpha (r = 0.417, p = 0.003) but not significantly correlated to IL-6 compared with the AGA group. In conclusion, the significant increase of AM, TNF-alpha and IL-6 in the idiopathic IUGR group might contribute to the uteroplacental haemodynamic alterations and can serve as a useful biochemical marker. Significant correlation between AM and TNF-alpha could hypothesise the existence of a complex interaction between AM and this inflammatory cytokine.