INTEGRATION OF CLINICAL AND IMMUNOLOGICAL PARAMETERS FOR PREECLAMPSIA RISK STRATIFICATION
Keywords:
preeclampsia, risk stratification, cardiovascular diseases, dyslipidemia, family history, cytokines, TNF α/IL 10 ratio, systemic inflammation, pregnancy outcomes, comorbid risk factors.Abstract
Beyond immune‑inflammatory mechanisms, premorbid somatic factors play a significant role in the pathogenesis of preeclampsia (PE); however, their contribution to cytokine imbalance and clinical severity remains insufficiently explored. Cardiovascular pathology, dyslipidemia, and a positive family history of PE may potentiate systemic inflammation and exacerbate gestational complications. This prospective study included 150 pregnant women (120 with PE and 30 uncomplicated pregnancies). Within the PE group, subgroups were defined based on the presence of pre‑existing arterial hypertension, obesity/dyslipidemia, and family history of PE. Multiplex cytokine assays (IL‑2, IL‑4, IL‑6, IL‑8, IL‑10, GM‑CSF, IFN‑γ, TNF‑α) were performed with calculation of integrated cytokine ratios. The risk of PE was assessed using multivariate logistic regression. The presence of two or more risk factors was associated with significantly higher pro‑inflammatory cytokines, earlier PE onset, more severe disease, and poorer perinatal outcomes. A combined clinical‑immunological model (≥2 risk factors + TNF‑α/IL‑10 >2.5) showed high predictive performance for severe PE (AUC=0.91). Incorporating these clinical parameters into comprehensive risk assessment alongside cytokine biomarkers enables more accurate patient stratification and timely adjustment of obstetric management.
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