Abstract
Objectives As inflammation has been associated with preeclampsia in cross-sectional analyses, we examined the relationship between inflammatory markers and preeclampsia in early pregnancy. Methods We conducted a nested case-control study of 409 preeclamptic women and 297 normotensive controls with primiparous singleton pregnancies enrolled in the Danish National Birth Cohort at a median gestation of 16 weeks. Preeclampsia was defined by blood pressure ⩾140/90 mmHg and proteinuria ⩾3 g/24 h. Inflammatory markers included interleukin (IL)-6, IL-6 receptor, IL-4, IL-4 receptor, IL-5, IL-12, IL-2, TNF-alpha, TNF-beta, TNF-receptor, IL-1beta IL-1alpha IL-8, IL-10, IFN-gamma, IL-18, macrophage migration inhibitory factor (MIF), macrophage inflammatory protein (MIP), transforming growth factor-beta (TGF), and RANTES. We examined associations between inflammatory markers dichotomized by the limit of detection (LOD) and preeclampsia using logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI). Models were adjusted for body mass index (BMI) and smoking. Results Women with IL-6 (OR 1.44, 95% CI 1.03–2.03) and TNF-alpha (OR 1.54, 95% CI 1.06–2.23) levels above the LOD have significantly increased risk of preeclampsia. IL-1beta levels above the LOD showed a decreased risk of preeclampsia (OR 0.55, 95% CI 0.3–1.01). Conclusions Elevated inflammatory markers in early pregnancy may be markers of subclinical disease and/or may be involved in pathogenesis. As these relationships are complex future studies should explore cytokine clusters in preeclampsia risk. Disclosures B.D. Taylor: None. G. Tang: None. R.B. Ness: None. J. Olsen: None. D.M. Hougaard: None. K. Skogstrand: None. J.M. Roberts: None. C. Haggerty: None.
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