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Fetal and maternal Doppler velocimetry and cytokines in high-risk pregnancy

Dubiel, M; Seremak-Mrozikiewicz, A; Breborowicz, GH; Drews, K; Pietryga, M and Gudmundsson, Saemundur LU (2005) In Journal of Perinatal Medicine 33(1). p.17-21
Abstract
Objective: Fetal hypoxia and preterm delivery are reported to be strongly associated with brain damage and neurodevelopmental delay. Doppler signs of fetal brain sparing have been described during chronic hypoxia, but whether they are related to brain damage is unknown. The aim of this study was to evaluate if markers of tissue injury, i.e., tumor necrosis factor-alpha. (TNF-alpha) and interleukin-6 (IL-6) are related to signs of increased perinatal vascular impedance and/or fetal brain sparing in high-risk pregnancies. Study design: TNF-alpha and IL-6 levels were evaluated in maternal blood serum of 67 high-risk pregnancies. Serum samples were taken at the time of umbilical, middle cerebral artery and uterine artery Doppler velocimetry... (More)
Objective: Fetal hypoxia and preterm delivery are reported to be strongly associated with brain damage and neurodevelopmental delay. Doppler signs of fetal brain sparing have been described during chronic hypoxia, but whether they are related to brain damage is unknown. The aim of this study was to evaluate if markers of tissue injury, i.e., tumor necrosis factor-alpha. (TNF-alpha) and interleukin-6 (IL-6) are related to signs of increased perinatal vascular impedance and/or fetal brain sparing in high-risk pregnancies. Study design: TNF-alpha and IL-6 levels were evaluated in maternal blood serum of 67 high-risk pregnancies. Serum samples were taken at the time of umbilical, middle cerebral artery and uterine artery Doppler velocimetry examination. The values for TNF-alpha and IL-6 were correlated with reference median values obtained with gestational age in the form of a Z-score. Results: TNF-alpha levels showed values within the normal range in only four cases. IL-6 values were found normal in 14 cases. The Z-score for mean middle cerebral artery pulsatility index (PI) showed a significant correlation to TNF-alpha and IL-6 levels, P < 0.0001 and P < 0.003, respectively. This might suggest a strong correlation between signs of fetal brain sparing and increased maternal serum TNF-alpha and IL-6 levels. Abnormal uterine artery PI and the presence of a "notch" were also highly significantly related to TNF-alpha and IL-6 levels, which were nearly two-fold higher compared to normal uterine artery blood flow and the absence of a "notch". Abnormal cerebro/placental ratios showed significant correlations to TNF-alpha and IL-6 levels. Conclusion: The present results suggest a strong correlation between levels of TNF-a and IL-6 not only for signs of fetal brain sparing, but also for uteroplacental blood flow. This finding supports the role of tissue injury in cases of fetal brain sparing, but whether this is a reflection of brain damage or secondary to placental pathology needs further evaluation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
tumor necrosis factor-alpha, placenta, interleukin-6, fetus, brain damage, Doppler velocimetry
in
Journal of Perinatal Medicine
volume
33
issue
1
pages
17 - 21
publisher
De Gruyter
external identifiers
  • pmid:15841608
  • wos:000226983500002
  • scopus:13844267318
ISSN
1619-3997
DOI
10.1515/JPM.2005.002
language
English
LU publication?
yes
id
acc45b7c-f7b9-478a-a645-8217a1ab3527 (old id 254305)
date added to LUP
2007-08-13 12:39:44
date last changed
2017-07-09 03:31:22
@article{acc45b7c-f7b9-478a-a645-8217a1ab3527,
  abstract     = {Objective: Fetal hypoxia and preterm delivery are reported to be strongly associated with brain damage and neurodevelopmental delay. Doppler signs of fetal brain sparing have been described during chronic hypoxia, but whether they are related to brain damage is unknown. The aim of this study was to evaluate if markers of tissue injury, i.e., tumor necrosis factor-alpha. (TNF-alpha) and interleukin-6 (IL-6) are related to signs of increased perinatal vascular impedance and/or fetal brain sparing in high-risk pregnancies. Study design: TNF-alpha and IL-6 levels were evaluated in maternal blood serum of 67 high-risk pregnancies. Serum samples were taken at the time of umbilical, middle cerebral artery and uterine artery Doppler velocimetry examination. The values for TNF-alpha and IL-6 were correlated with reference median values obtained with gestational age in the form of a Z-score. Results: TNF-alpha levels showed values within the normal range in only four cases. IL-6 values were found normal in 14 cases. The Z-score for mean middle cerebral artery pulsatility index (PI) showed a significant correlation to TNF-alpha and IL-6 levels, P &lt; 0.0001 and P &lt; 0.003, respectively. This might suggest a strong correlation between signs of fetal brain sparing and increased maternal serum TNF-alpha and IL-6 levels. Abnormal uterine artery PI and the presence of a "notch" were also highly significantly related to TNF-alpha and IL-6 levels, which were nearly two-fold higher compared to normal uterine artery blood flow and the absence of a "notch". Abnormal cerebro/placental ratios showed significant correlations to TNF-alpha and IL-6 levels. Conclusion: The present results suggest a strong correlation between levels of TNF-a and IL-6 not only for signs of fetal brain sparing, but also for uteroplacental blood flow. This finding supports the role of tissue injury in cases of fetal brain sparing, but whether this is a reflection of brain damage or secondary to placental pathology needs further evaluation.},
  author       = {Dubiel, M and Seremak-Mrozikiewicz, A and Breborowicz, GH and Drews, K and Pietryga, M and Gudmundsson, Saemundur},
  issn         = {1619-3997},
  keyword      = {tumor necrosis factor-alpha,placenta,interleukin-6,fetus,brain damage,Doppler velocimetry},
  language     = {eng},
  number       = {1},
  pages        = {17--21},
  publisher    = {De Gruyter},
  series       = {Journal of Perinatal Medicine},
  title        = {Fetal and maternal Doppler velocimetry and cytokines in high-risk pregnancy},
  url          = {http://dx.doi.org/10.1515/JPM.2005.002},
  volume       = {33},
  year         = {2005},
}