Inflammatory cytokines in intrauterine growth retardation

Background. To evaluate maternal serum levels of two inflammatory cytokines in women with intrauterine growth retardation (IUGR), while studying separately women with or without placental insufficiency. Methods. The study comprised 14 women with IUGR and Doppler-defined placental insufficiency, 14 women with IUGR without placental insufficiency, and 28 healthy pregnant women as a control group. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured using a commercially available kit. The Kruskal-Wallis test and the corrected Mann-Whitney U-test were used. Results. There was a statistically significant difference in TNF-alpha levels among the three studied groups (p=0.03). Women with IUGR and placental insufficiency showed statistically significant higher serum levels of TNF-alpha[2.2 pg/mL (1.3-4.1)] and a higher rate of detectable TNF-alpha[85.7% (12/14)] than those in the control group [0 pg/mL (0-2.7) and 32.1% (9/28)] (p=0.01 and p=0.001, respectively). On the contrary, there was no difference in either the TNF-alpha level [1.4 pg/mL (0-4.9)] or the rate of detectable TNF-alpha[57.1% (8/14)] between women with IUGR without placental insufficiency and women in the control group. The levels of IL-6 were similar in the three studied groups. Conclusion. TNF-alpha is increased in women with IUGR and placental insufficiency but normal in those with IUGR and normal placental perfusion. We suggest that elevations of TNF-alpha could be a specific phenomenon of certain subsets of IUGR, identifying cases with placental dysfunction.