Cytokines in the perinatal period – Part II

• The complexity of cytokine function is highlighted in normal and pathologic conditions of pregnancy.
• Cytokine biology is key to understanding the pathophysiology of pregnancy-specific diseases.
• Many diseases of pregnancy are characterized by a pro-inflammatory state.
• Anesthetic agents and techniques influence cytokine expression in pregnancy.

A contemporary, robust immunologic explanation for common obstetric conditions remains elusive; why some pregnant women are more susceptible to developing preeclampsia or preterm labor is not completely understood. We explore the immunology behind four important and commonly encountered pregnancy-related conditions: preeclampsia, recurrent miscarriage, preterm labor and gestational diabetes. For each condition, we summarize the current understanding of cytokines implicated in the pathogenesis, discuss the impact of anesthesia and analgesia on selected cytokine profiles, and suggest potential opportunities for clinical and research interventions.