Estimation of inflammatory cytokines in maternal serum for assessing the outcome of threatened miscarriage.

ABSTRACT

Objectives: This study investigates the use of pro- and anti-inflammatory cytokines in predicting the outcome of pregnancy complicated by threatened miscarriage. Materials and Methods: Of the 140 eligible pregnant women recruited for the study, maternal serum levels of selected inflammatory cytokines (IL-2, IFNγ, IL-4, and IL-13) for 70 women with threatened miscarriage were analysed for this study. Serum concentrations were measured using the enzyme-linked immunosorbent assay (ELISA) kit. Inevitable miscarriage or ongoing pregnancy was used as the outcome, whereas serum levels of selected inflammatory cytokines, women's sociodemographic characteristics, gynaecologic history, and clinical history were used as the explanatory variables. The Student's t test was used to compare the cytokine profiles between women with inevitable miscarriages and women with normal ongoing pregnancy after 13 weeks of gestation. Poisson regression models were performed to investigate the factors associated with inevitable miscarriage. Results: The result revealed significantly higher pro-inflammatory cytokines, IL-2 (P < 0.001), and IFNγ (P < 0.001) in women with a pregnancy that resulted in an inevitable miscarriage than in those that resulted in an ongoing pregnancy. The incidence rate of inevitable miscarriage increased by 16% (IRR = 1.16, 95% CI 0.58-2.32) for a unit increase in IL-2 and by 25% (IRR = 1.25, 95% CI 1.09-1.43) when adjusted for sociodemographic characteristics, gynaecology, and clinical history. Conclusion: The IL-2 was the best biomarker for predicting the outcome of threatened pregnancy with a sensitivity of 80% and a specificity of 70% at 1.30 pg/mL cut-off point.