Plasma TNF-α Levels are Higher in Early Pregnancy in Patients with Secondary Compared with Primary Recurrent Miscarriage

ProblemSpecific pro-inflammatory cytokine profiles in plasma may characterize women with recurrent miscarriage (RM) but the dynamics of the cytokine profiles with progressing pregnancy is largely unknown. Method of studyPlasma was repeatedly sampled in the first trimester from 47 RM patients. The concentrations of five cytokines including tumour necrosis factor alpha (TNF-) were measured. TNF- levels were correlated to carriage of five TNFA promoter polymorphisms. ResultsTNF- levels increased (P=0.014) with progressing pregnancy, with higher levels in secondary than primary RM (P=0.042) but with no significant impact on outcome. Carriage of TNFA -863C and TNFA -1031T was associated with higher TNF- levels, and the former was found more often in secondary than primary RM (P<0.02). ConclusionPlasma TNF- levels increase during early pregnancy in RM women regardless of outcome, but are higher in secondary than primary RM, which may be partly genetically determined.