Inflammatory cytokines, placental pathology, and neurological outcomes in infants born to preterm preeclamptic mothers

PLoS One. 2021 Nov 15;16(11):e0260094. doi: 10.1371/journal.pone.0260094. eCollection 2021.

Abstract

Preeclampsia is both a vascular and inflammatory disorder. Since the placenta is a conduit for fetal development, preeclampsia should be a presumed cause of adverse infant outcomes. Yet, the relationship of placental pathology, inflammation and neurological outcomes after preeclampsia are understudied. We prospectively examined a cohort of maternal-infant dyads with preeclampsia for maternal inflammatory cytokines at time of preeclampsia diagnosis and delivery, and fetal cord blood cytokines (IL-1β, IL-6, IL-8, and TNF-α). Placentas were analyzed for inflammatory and vascular pathologies. Neurodevelopmental assessment of infants utilizing the Pediatric Stroke Outcome Measure (PSOM) was conducted at 6-month corrected gestational age. Eighty-one maternal-newborn dyads were examined. Worse neurological outcomes were not associated with elevated maternal / fetal cytokines. Early preterm birth (gestational age ≤ 32 weeks) was associated with worse neurological outcomes at 6-months regardless of maternal/ fetal cytokine levels, placental pathology, or cranial ultrasound findings (OR 1.70, [1.16-2.48], p = 0.006). When correcting for gestational age, elevated IL-6 approached significance as a predictor for worse developmental outcome (OR 1.025 [0.985-1.066], p = 0.221). Pathological evidence of maternal malperfusion and worse outcomes were noted in early preterm, although our sample size was small. Our study did not demonstrate an obvious association of inflammation and placental pathology in preeclampsia and adverse neurodevelopmental outcome at 6-month corrected age but does suggest maternal malperfusion at earlier gestational age may be a risk factor for worse outcome.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Fetal Blood / immunology
  • Fetal Development
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Interleukin-6 / metabolism*
  • Maternal Age
  • Middle Aged
  • Placenta / immunology
  • Placenta / pathology*
  • Pre-Eclampsia / immunology*
  • Pregnancy
  • Premature Birth / immunology*
  • Prospective Studies
  • Up-Regulation*
  • Young Adult

Substances

  • IL6 protein, human
  • Interleukin-6

Grants and funding

NIH BIRCWH K12 KD HDO57022 (JA), AHA SouthWest Affiliates Clinical Research Grant 10CRP3670014 (JA), and Maternal and Child Bureau 340B program H30MC24049 (JA). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.