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-alpha[2.2 pg/mL (1.3-4.1)] and a higher rate of detectable TNF-alpha[85.7% (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-alpha[57.1% (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.