Chemokines' profile as early predictor for complicated pregnancy among primigravida at high-risk of toxoplasmosis.

Background: Toxoplasmosis is a rare but significant infection in pregnant women. It can cause serious fetal harm. Although methods for screening, diagnosing, and treating toxoplasmosis during pregnancy have been evaluated, robust evidence is still lacking. Antenatal treatment can reduce fetal and neonatal morbidity. Objective: To evaluate the distinguishing ability of serum chemokines for primigravida vulnerable to develop toxoplasmosis and its-related pregnancy complications. Patients and Methods: The study included three groups of pregnant women; 60 primigravida (A), 60 primigravida free of high-risk criteria for toxoplasmosis (B), and 60 multigravida who had a history of toxoplasmosis-related pregnancy complications (C). Blood samples were obtained to assess seropositivity for anti-T. gondii immunoglobulin (Ig) M and G, and for ELISA estimation of serum levels of interleukin-6 (IL-6), C-X-C chemokine-ligand-9 (CXCL9), chemotactic-competent motif ligand-2, and -5 (CCL2 and CCL5). Ability of the estimated parameters to predict the reported pregnancy complications was evaluated. Results: Group A samples were more seropositive and showed significantly higher CXCL9 levels than group B samples. In seropositive patients, CCL2 and 5 levels were significantly higher in group A, while in group B samples, only serum CCL2 levels were significantly higher. In addition, CCL2 levels were higher in IgG+ or IgG+/IgM+ of group B than in group A subjects. Serum IL-6 levels were significantly higher in seropositive than seronegative women and in IgM+ than in IgG+ or IgG+/IgM+ samples of both groups. Pregnancy complications were significantly frequent among group A women. While high CXCL9 levels alone could predict pregnancy complications, high IL-6 levels could predict seropositivity, and seropositivity might predict spontaneous abortion or early pregnancy loss (EPL). Conclusion: Serum CXCL9 and CCL2 levels could distinguish women vulnerable to developing pregnancy complications. High CXCL9 levels could predict spontaneous abortion or EPL, while coupled with high IL-6 levels it could distinguish seropositivity in primigravida.