CYTOKINE PROFILE IMBALANCE IN PREECLAMPSIA: ASSOCIATION WITH GESTATIONAL AGE AT ONSET AND PERINATAL OUTCOMES
Keywords:
preeclampsia, cytokine profile, Th1/Th2 imbalance, TNF α/IL 10 ratio, gestational age, perinatal outcomes, early onset preeclampsia, systemic inflammation, risk stratification, preterm delivery.Abstract
Preeclampsia (PE) is a leading cause of maternal and perinatal morbidity, with immune dysregulation and a shift toward the pro‑inflammatory Th1 phenotype considered key pathogenetic mechanisms. However, the temporal dynamics of this imbalance across different gestational ages remain insufficiently characterized. This prospective comparative study included 150 pregnant women (120 with PE, 30 uncomplicated controls). PE patients were stratified by gestational age at onset: <34 weeks, 34–36 weeks, and ≥37 weeks. Plasma concentrations of IL‑2, IL‑4, IL‑6, IL‑8, IL‑10, GM‑CSF, IFN‑γ, and TNF‑α were measured using multiplex assay; integrated cytokine ratios (TNF‑α/IL‑10, IFN‑γ/IL‑4, IL‑2/IL‑4) were calculated. All PE patients exhibited a pronounced cytokine imbalance, with the most substantial alterations in early‑onset PE (<34 weeks). Integrated ratios showed greater discriminatory capacity than absolute cytokine values. TNF‑α/IL‑10 ratio correlated negatively with neonatal birth weight, and was a strong predictor of severe PE and preterm delivery (AUC=0.87). Assessment of the cytokine profile, particularly a TNF‑α/IL‑10 ratio threshold >2.5, may serve as an adjunctive objective criterion for risk stratification and for guiding the timing of therapeutic intervention and delivery in pregnancies complicated by preeclampsia.
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