PERINATAL ASPECTS OF IMMUNOLOGICAL DISTURBANCES IN PREGNANT WOMEN AFTER INFLUENZA TRANSFERRED IN THE EARLY TIME

Abstract

The aim of the study was to study the characteristics of the immunity of pregnant women after suffering from influenza in the early stages of gestation and to assess the perinatal aspects of the revealed changes.Materials and research methods. We examined 120 women who had had flu in the first trimester of pregnancy. Two groups were identified: the main group - 68 patients with placental dysfunction, the comparison group - 52 pregnant women without signs of placental insufficiency. Natural killer cell cytotoxicity was assessed using flow cytometry. The level of cytokines in the peripheral blood has been studied by enzyme immunoassay. Statistical processing was carried out using the odds ratio (OR).Research results. For women with placental insufficiency after influenza transferred in early pregnancy, both an increase and a decrease in NK cytotoxicity are characteristic, which increases the risk of placental insufficiency several times (from 2.87 to 5.03 by OR for each indicator or their combination). The increase in indicators, which indicates a high pro-inflammatory potential and the damaging effect of NK cells, has a higher predictive value than a decrease. There is an imbalance in the cytokine profile, mainly in the pro-inflammatory direction. The highest OR values show an increase in TNF levels over 8 pg / ml (OR = 4.17) and an increase in the ratio of pro- and anti-inflammatory cytokines IL-1 / IL-10> 1.3 (OR = 3.44). Most often, placental dysfunction was associated with fetal distress (76.5%) and delayed growth (54.4%); there was a high incidence of asphyxia at birth (46.5%). In half (51.5%) of the children, various syndromes of dysadaptation were observed, most often neurological disorders (32.4%) and respiratory disorders (27.9%) were observed.Conclusions. Excessive inflammatory reaction, combined with an increase in NK-cytotoxicity, has a damaging effect on the endothelium, and a decrease in immune responses, causes a prolonged course of influenza and insufficient immune control of the trophoblast invasion processes. Immune regulation disorders were noted in pregnant women after the early influenza infection, which, when combined with possible hormonal dysfunctions, lead to the formation of placental dysfunction and a high frequency of perinatal complications.