Objective:We examined the hypothesis tha fetal proinflammatory cytokine release is a feature of placental vascular disease causing fetal compromise. We measured the concentrations of fetal proinflammaory cytokines interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and interleukin-8 (IL-8) in the presence of vascular disease in the umbilical placental villous circulation. Vascular disease was identified by high-resistance umbilical artery Doppler flow velocity waveform studies.
Methods:We measured levels of the inflammatory cytokines IL-6 and TNF-α and the chemokine IL-8 in fetal blood. Blood was collected from the umbilical vein at delivery, and serumwas stored at -70C until assayed using chemiluminescent and enzyme-linked immunosorbent assay methods. We studied 36 normal pregnancies delivered by elective cesarean at term and 50 pregnancies with a high-resistance umbilical artery Doppler flow velocity waveform pattern indicative of feal placental vascular disease delivered by elective cesarean because of potential fetal compromise.
Results:In the presence of umbilical placental vascular disease there were significantly higher levels of IL-6 (median 5.3 pg/mL, P < .05) and IL-8 (median 26.5 pg/mL, P < .01) compared with normal pregnanices (median value of IL-6 and IL-8 were below assay threshold). There was no difference for TNF-α,with the median results undetectable in both groups.
Conclusion:We found higher concentrations of IL-6 and IL-8 in the fetal circulation in the presence of umbilical placental vascular disease.
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