Repeated Measures of Cervicovaginal Cytokines during Healthy Pregnancy: Understanding “Normal” Inflammation to Inform Future Screening

Miatta A. Buxton; Noemi Meraz-Cruz; Brisa N. Sánchez; Betsy Foxman; Carina J. Gronlund; Jorge Beltran-Montoya; Marisol Castillo-Castrejon; Marie S. O'Neill; Felipe Vadillo-Ortega

doi:10.1055/s-0039-1685491

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2020; 37(06): 613-620
DOI: 10.1055/s-0039-1685491

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Repeated Measures of Cervicovaginal Cytokines during Healthy Pregnancy: Understanding “Normal” Inflammation to Inform Future Screening

Miatta A. Buxton

¹Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan

,

Noemi Meraz-Cruz

²Unidad de Vinculación Científica de la Facultad de Medicina, Universidad Nacional Autónoma de México en el Instituto Nacional de Medicina Genómica, Mexico City, Mexico

,

Brisa N. Sánchez

³Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan

,

Betsy Foxman

⁴Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan

,

Carina J. Gronlund

⁵Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan

,

Jorge Beltran-Montoya

⁶Sub-comité Académico de Ginecología y Obstetricia, Universidad Nacional Autónoma de México, Mexico City, Mexico

,

Marisol Castillo-Castrejon

¹Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan

,

Marie S. O'Neill

¹Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan

⁴Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan

,

Felipe Vadillo-Ortega

¹Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan

²Unidad de Vinculación Científica de la Facultad de Medicina, Universidad Nacional Autónoma de México en el Instituto Nacional de Medicina Genómica, Mexico City, Mexico

› Institutsangaben

Abstract

Objective This study aimed to describe characteristics of cervicovaginal cytokines obtained during pregnancy from women who subsequently delivered at term.

Study Design We used repeated measures of 20 cervicovaginal cytokines, collected on average on a monthly basis, from the second to the ninth month of gestation among 181 term pregnancies in the Mexico City Pregnancy Research on Inflammation, Nutrition, & City Environment: Systematic Analyses cohort (2009–2014). Cytokines were quantified using multiplex assay.

Results Cytokine distributions differed more between than within cytokines. Across trimesters, cytokines interleukin (IL)-1Ra, IL-1α, and IL-8 consistently had high concentrations compared with other measured cytokines. Cytokine intraclass correlation coefficients ranged from 0.41 to 0.82. Spearman's correlation coefficients among cytokine pairs varied but correlation directions were stable; 95.3% of the 190 correlation pairs remained either negative or positive across trimesters. Mean longitudinal patterns of log-transformed cytokines from Tobit regression varied across but less within cytokines.

Conclusion Although mean concentrations of cervicovaginal cytokines among term pregnancies were high, they were largely stable over time. The high cytokine concentrations corroborate that pregnancy is associated with an active inflammatory state. These characterizations may serve as a baseline for comparison to other obstetric outcomes, which may be helpful in understanding deviations from normal gestational inflammation.

Keywords

appropriate statistical methods - cytokines - inflammation - patterns - longitudinal data - pregnancy - PRINCESA cohort - Tobit regression - term birth

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