Changes in the systemic inflammatory response in women in the third trimester of pregnancy complicated by exacerbation of cytomegalovirus infection

Aim. To study the change in the systemic inflammatory response in women in the third trimester of pregnancy complicated by exacerbation of cytomegalovirus infection (CMVI). Materials and methods. The study involved 120 women with a physiological course of gestation and with a pregnancy complicated by CMVI. The first group was represented by 30 seronegative women at 31-34 weeks of gestation, the second – by 30 pregnant women with a latent course of CMVI and placental insufficiency, the third – 30 women with exacerbation of CMVI and placental insufficiency; and the fourth – 30 patients with exacerbation of CMVI, initiating the development of placental insufficiency and threatened miscarriage. Results. In the blood serum of women in the first group, the TNF-α content was 14.7 (12.1-32.0) pg/mL, IFN-γ – 128.7 (117.0-172.5) pg/mL, IL-1β – 20.3 (13.8-35.3) pg/mL, IL-6 – 2,57 (2,10-2,73) pg/mL, IL-4 – 37,8 (30,0- 55,4) pg/mL and IL-2 – 34,3 (29,4-41,3) pg/mL. The patients of the second group, in comparison with the first one, were diagnosed with an increase in the median TNF-α to 29.5 (14.4-43.1) pg/mL (p=0.0168) and IL-2 – 40.7 (33.2-47.9) pg/mL (p=0.0169) against the background of the absence of significant differences in the concentration of IFN-γ, IL-1β, IL-6 and IL-4. In the third group, compared with the second one, the concentration of TNF-α increased by 2.74 times (p=0.000001), IFN-γ – by 1.69 times (p=0.000001), IL-1β – by 3.16 times (p=0.000001), IL-6 – 2.17 times (p=0.000001), IL-2 – 2.2 times (p=0.000001) and there were no differences in the concentration of IL-4 (p=0.994). In the fourth group, compared with the third one, an increase in TNF-α level was diagnosed by 1.03 times (p=0.028), IFN-γ – by 1.18 times (p=0.017), IL-1β – by 1.64 times (p=0.000001), IL-6 – by 1.49 times (p=0.0035), IL-2 – by 1.32 times (p=0.000001) against the background of a drop in IL-4 level by 1.52 times (p=0.00031). Conclusion. Increase in serum concentration of pro-inflammatory cytokines (TNF-α, IFN-γ, IL-1β, IL-6 and IL-2) against the background of a decrease in the level of anti-inflammatory cytokine (IL-4) in women with exacerbation of CMVI in the third trimester of gestation, complicated by placental insufficiency, plays an important role in the pathogenesis of threatened preterm labor.

systemic inflammatory response, cytokines, cytomegalovirus infection, pregnancy, the threat of miscarriage

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