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Involvement of inflammation in normal pregnancy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
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2013 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, no 5, 601-605 p.Article in journal (Refereed) Published
Abstract [en]

Objective.

To study the role of inflammatory biomarkers of cytokine and cyclooxygenase origin throughout normal pregnancy and postpartum.

Design.

Longitudinal prospective study.

Setting.

One outpatient antenatal clinic in Uppsala, Sweden.

Population.

Thirty-seven healthy women with normal pregnancies and normal neonatal outcome were included. 

Methods.

Blood and urine samples were collected from each woman at least 6 times during pregnancy and postpartum. Plasma levels of IL-6 and TNF-α were measured by using ELISA kits and urine levels of PGF2α metabolite were measured by using RIA.

Main outcome measures.

Median plasma and urine levels, the 25:th to the 75:th percentile and the average change per gestational week of IL-6, TNF-α and PGF2α metabolite .

Results.

IL-6 levels increased significantly throughout pregnancy and postpartum levels remained high. No change in TNF-α could be seen with advancing gestational age or postpartum period. The PGF2α metabolite levels increased significantly throughout pregnancy and decreased in postpartum period.

Conclusion.

These results suggest that mild but significant inflammatory activity is involved in development of normal pregnancy and might have important physiological effects.

Place, publisher, year, edition, pages
2013. Vol. 92, no 5, 601-605 p.
Keyword [en]
IL-6, Inflammation, Pregnancy, TNF-α and PGF2α
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-171156DOI: 10.1111/aogs.12093ISI: 000319060200016PubMedID: 23506129OAI: oai:DiVA.org:uu-171156DiVA: diva2:510294
Available from: 2012-03-15 Created: 2012-03-15 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Oxidative Stress, Angiogenesis and Inflammation in Normal Pregnancy and Postpartum
Open this publication in new window or tab >>Oxidative Stress, Angiogenesis and Inflammation in Normal Pregnancy and Postpartum
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims were to investigate oxidative stress (I), angiogenesis (II) and inflammation (III-IV) in healthy women during pregnancy and postpartum. Oxidative stress was estimated by measurement of 8-iso-PGF and the antioxidants α- and γ-tocopherol. The angiogenic factors PlGF, VEGF-A and the antiangiogenic factor sFlt1 were measured to estimate angiogenesis. PTX3, IL-6, TNF-α and a PGF metabolite were measured to estimate inflammation.

Out of 52 included women, 15 had minor pregnancy complications and 37 were classified as normal. In study III data from all 52 women were used. For the other studies (I, II and IV) only data from the 37 women with normal pregnancy were used. Pregnancy was associated with increased levels of 8-iso-PGF with advancing gestational age. The median postpartum value corresponded to values observed in early gestation and a significant decrease was observed from late pregnancy to postpartum. Lipid-adjusted α- and γ-tocopherol levels decreased with advancing gestational age (I). PlGF increased from early pregnancy until weeks 29–30 and thereafter decreased until week 40. sFlt1 levels were relatively constant until weeks 29–30, when they increased, reaching a peak at weeks 39–40. Postpartum levels were low. The sFlt1:PlGF ratio decreased from weeks 9–12, was constantly low from weeks 19–20 to 37–38 and then increased to weeks 39–40. VEGF-A was detectable in only 8 % of the samples during pregnancy and in 64 % postpartum (II). There was a continuous increase of PTX3 as pregnancy progressed. The increase was most evident after week 31 with the highest levels just before delivery (III). IL-6 increased throughout pregnancy and remained high postpartum. No change in TNF-α could be seen with advancing gestational age or postpartum. The PGF metabolite levels increased throughout pregnancy and decreased postpartum (IV).

In conclusion, normal pregnancy is associated with mild oxidative stress and inflammation. This might have physiological effects for normal pregnancy development. By delineating how these mediators of oxidative stress, angiogenesis and inflammation fluctuate throughout normal pregnancy and postpartum, we have established a reference for studies of these factors in pregnancy complications.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 63 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 753
Keyword
Angiogenesis, inflammation, IL-6, F2-isoprostanes, oxidative stress, Pentraxin 3, PGF2α, PlGF, pregnancy, sFlt1, TNF-α, VEGF-A
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology; Medical Science
Identifiers
urn:nbn:se:uu:diva-171165 (URN)978-91-554-8314-2 (ISBN)
Public defence
2012-05-04, Brömssalen, entrance 11, Gävle Sjukhus, Gävle, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2012-04-23 Created: 2012-03-15 Last updated: 2012-08-01Bibliographically approved

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Palm, MariaAxelsson, OveWernroth, LisaLarsson, AndersBasu, Samar

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