IS PLACENTAL INFLAMMATION A RISK FACTOR FOR INTRAUTERINE GROWTH RESTRICTION?
Krishna Rao Gurugubelli, Vishnu Bhat Ballambattu*, Zacheriah Bobby, Bhawana Badhe, Dasari Papa
ABSTRACT
Background: Intrauterine growth restriction (IUGR) is a pregnancy associated disease manifested by decreased growth rate of fetus than the normal genetic potential. IUGR represents a human model of chronic fetal hypoxia. Hypoxia induced ischemic tissue injury leads to inflammation and production of pro inflammatory cytokines. Objectives: To investigate the relation of inflammatory mediators in cord blood with intrauterine growth restriction. Methods: This cohort study was conducted in the Neonatology Department, JIPMER, a tertiary care hospital in south India from August 2016 to July 2017. Thirty seven (37) IUGR and thirty eight (38) AGA neonates were recruited. Umbilical cord blood samples were collected at birth and anthropometric measurements were recorded. Plasma was separated from the cord blood samples and TNF-α, IL-6 were measured using high sensitivity enzyme linked immunosorbent assay (ELISA) kits. Levels of inflammatory mediators were correlated with anthropometric measurements of babies using statistical tests. Results: IUGR neonates had lower birth weight (BW), birth length (BL) and head circumference (HC). Their plasma levels of IL-6 were significantly higher in the unadjusted model. The results of stepwise multivariate linear regression analysis showed that after adjusting for sex, gestational age, birth weight, birth length and head circumference, there was no significant difference in IL-6 levels between IUGR and AGA babies (p=0.09). TNF-α was also not significantly associated with any of the variables (F=0.8). Conclusion: Our study demonstrated that, in adjusted model both IUGR and AGA had comparable IL-6 and TNF-α level suggesting that placental inflammation may not be a risk factor IUGR.
Keywords: Intrauterine growth restriction; Inflammatory mediators; Placenta; Cord blood plasma.
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