Pre-pregnancy maternal plasma cytokine levels and risks of small-for-gestational-age at birth.

OBJECTIVES

Small-for-gestational-age (SGA) results from abnormalities of the feto-placental-maternal unit. Cytokine profiles during early pregnancy may predict placental changes that lead to SGA, however it is unknown if these altered profiles precede conception. We examined the role of maternal cytokines prior to conception as risk factors for subsequent delivery of an SGA infant.

METHODS

We included a sample of 80 women and their offspring from a large trial of pre-conceptual multiple micronutrient supplementation. Plasma samples collected before conception were tested with a high sensitivity multiplex assay for IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IFNγ, and TNFα.

RESULTS

Pre-conceptual IL-13 and IFNγ were lower in women who gave birth to an SGA child than among control women (0.81 versus 1.14 pg/ml and 7.81 versus 11.01 pg/ml, respectively). Multivariable logistic regression showed that IL-13 (p = 0.029) and IFNγ (p = 0.015) were both inversely associated with SGA.

CONCLUSIONS

These results suggest maternal immune function prior to conception may indicate an unfavorable immune balance leading to placental abnormalities and high risk of SGA. Preconception assessment of cytokine profiles could potentially contribute to early detection of SGA and to the timely implementation of interventions to prevent it.