Macrophage colony-stimulating factor (M-CSF) in first trimester maternal serum: correlation with pathologic pregnancy outcome

Arch Gynecol Obstet. 2016 Jun;293(6):1213-7. doi: 10.1007/s00404-015-3931-7. Epub 2015 Nov 4.


Purpose: To determine correlations between macrophage colony-stimulating factor (MCSF) levels in maternal blood during first trimester screening with respect to normal and pathological pregnancies.

Methods: This was a prospective single centre study. First trimester screening was performed according to FMF London certificates. Nuchal translucency, PAPP-A and free β-HCG were obtained as well as M-CSF serum levels in maternal blood. Fetal karyotyping was achieved by chorionic villi sampling.

Results: 125 patients were enrolled in this study. 21 pregnancies had confirmed aberrant karyotypes. Trisomy 21 cases showed significantly elevated M-CSF levels of 270 ± 91 pg/ml (p = 0.032), whereas cases of trisomy 13 (183 ± 68 pg/ml) and trisomy 18 (143 ± 40 pg/ml) had low M-CSF levels. Furthermore M-CSF levels tended to be low in preterm deliveries, placental insufficiency and nicotine consumption. In cases with gestational diabetes M-CSF tended to be elevated. Furthermore we found a positive correlation between high free β-human chorionic gonadotropin (hcg) and MCSF values. There was no correlation between pregnancy associated plasma protein (PAPP-A) and M-CSF.

Conclusions: M-CSF is a cytokine promoting placental growth and differentiation. M-CSF is known to be involved in the process of implantation in pregnancy. The role of M-CSF with respect to disturbed pregnancy outcomes such as placental insufficiency in normal or aberrant karyotypes, for example, is yet subject to further research.

Keywords: Aberrant karyotype; Cytokines; Placental insufficiency; Preterm delivery; Trisomy 21.

MeSH terms

  • Adult
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Chromosome Aberrations*
  • Chromosome Disorders / blood
  • Chromosomes, Human, Pair 13
  • Chromosomes, Human, Pair 18
  • Diabetes, Gestational / blood
  • Down Syndrome / blood
  • Female
  • Humans
  • Karyotyping
  • London
  • Macrophage Colony-Stimulating Factor / blood*
  • Nuchal Translucency Measurement
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, First / blood
  • Pregnancy-Associated Plasma Protein-A / analysis
  • Premature Birth / blood
  • Prenatal Diagnosis / methods
  • Prospective Studies
  • Trisomy
  • Trisomy 13 Syndrome


  • Chorionic Gonadotropin, beta Subunit, Human
  • Macrophage Colony-Stimulating Factor
  • Pregnancy-Associated Plasma Protein-A