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Clinical Obstetrics

Poster Session 1

(144) Changes in cytokine levels during progression in twin gestations and association with pregnancy outcome

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To evaluate the plasma concentrations of multiple cytokines during each trimester of twin pregnancies and identify associations with preterm birth and gestational age at delivery.

Study Design: This prospective, observational study was conducted at Careggi University Hospital, Florence, Italy. Plasma from 82 women with twin pregnancies was collected in each trimester for measurement of multiple cytokines (IL-1β, IL-6, IL-10, IL-12p70, TNF-α). Demographic and clinical outcome data were subsequently obtained by chart review. Data were analyzed by Friedman pairwise comparison or Wilcoxon analysis with the Bonferroni correction and the Mann-Whitney test.

Results: 78 women were White, 2 were Asian and 2 were African. Their median (interquartile range) age was 35 (33, 38) years old. Body mass index was 21.5 (19.6, 23,9) kg/m2. Thirty of the women (36.6%) conceived by assisted reproduction technology, either intrauterine insemination or in vitro fertilization. The mean age at sample collection was 12.2 weeks in the first trimester, 22.0 weeks in the second trimester and 31.0 weeks in the third trimester. Gestational diabetes mellitus was diagnosed in 17 (21.0%) of the women. The mean (standard deviation) gestational age at delivery was 36.0 (1.6) weeks and 9 women (11.0%) had a spontaneous preterm birth. Gestational age at delivery was inversely correlated with the TNF- α concentration in the second (p = 0.015) and third (p< 0.002) trimester.  TNF- α was also positively associated with preterm birth in the second and third trimester (p = 0.042 and 0.023, respectively). The IL-6 level in the third trimester was also associated with gestational age at delivery (p < 0.002). The IL-1 β concentration in 3rd trimester was positively associated with gestational diabetes mellitus (p=0.022). Additionally, plasmatic cytokines concentrations and their comparison between the three trimesters were reported in Table 1. Values are reported as median and interquartile range.

Conclusion: Quantitation of TNF-a and IL-6 in plasma are predictors of earlier gestational age at delivery in multifetal gestations.