First and second trimester immune biomarkers in preeclamptic and normotensive women.
OBJECTIVE To evaluate the hypothesis that cytokine levels are associated with miscarriage risk using serum samples collected before report of miscarriage. DESIGN A nested case-control study. SETTING Biospecimens from the multisite Collaborative Perinatal Project, University of Florida, laboratory assessment of interleukin (IL)-1 receptor antagonist, IL-1beta, IL-4, IL-6, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, thrombopoietin (TPO), and granulocyte colony-stimulating factor (G-CSF). PATIENT(S) Cases of miscarriage (n = 439) were matched to controls (n = 373) by gestational age at sample collection. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Miscarriage. RESULT(S) Increased risk of miscarriage was associated with elevated TPO (adjusted odds ratio [OR] 1.16, 95% confidence interval [CI] 1.00-1.36) and decreased G-CSF (adjusted OR 0.78, 95% CI 0.64-0.95). When analysis was restricted to samples collected more than 35 days before miscarriage, the effect of G-CSF was not observed (adjusted OR 0.96, 95% CI 0.72-1.28), whereas increased risk related to higher TPO remained. CONCLUSION(S) Circulating levels of TPO may be associated with increased risk of miscarriage.