Longitudinal changes in serum proinflammatory markers across pregnancy and postpartum: Effects of maternal body mass index

- Excessive inflammation has been associated with a variety of adverse perinatal health.
- Serum cytokines show different trajectories of change across pregnancy and postpartum.
- Deviations from typical trajectories may predict adverse perinatal outcomes.
- Obese women have elevated serum proinflammatory markers across gestation and postpartum.
- Effects of obesity-induced inflammation on maternal and fetal health are not fully explicated.

BackgroundThe maternal immune system undergoes substantial changes to support healthy pregnancy. Although obesity is a primary driver of inflammation and predictive of perinatal complications, additive effects of pregnancy and obesity on changes in inflammatory processes are not well delineated.MethodsThis study examined serum proinflammatory markers interleukin(IL)-6, IL-8, tumor necrosis factor (TNF)-α, IL-1β, and C-reactive protein (CRP) during each trimester of pregnancy and 4-6 weeks postpartum among 57 women.ResultsOverall, IL-6 showed an increasing trend across pregnancy and significant increase at postpartum. Similarly, TNF-α increased significantly across gestation, with a further increase at postpartum. Both IL-8 and IL-1β showed a U-shaped curve, decreasing from early to later pregnancy, and increasing at postpartum. Finally, serum CRP decreased significantly across pregnancy, with further decreases at postpartum. Maternal obesity predicted higher IL-6 at each study visit. Obese women showed a trend toward elevated serum CRP during pregnancy, and significantly higher levels at postpartum.DiscussionThe course of pregnancy and postpartum is characterized by significant changes in serum proinflammatory mediators. Obese women show elevations in serum proinflammatory markers relative to normal weight women during pregnancy and postpartum. Further research is needed to determine the extent to which obesity-induced inflammation affects maternal and fetal health.