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-alpha2.2 pg/mL (1.3-4.1) and a higher rate of detectable TNF-alpha85.7% (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-alpha57.1% (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.