Endocrine-immune factors in patients of reproductive age with hyperproliferative diseases of the uterus against the background of the threat of early abortion

The main causes of adverse perinatal outcomes are miscarriage, placental dysfunction, gestosis, which are caused by hyperproliferative diseases of the uterus (HPD), past inflammatory diseases of the internal genital organs (IDIGO) and stress. Aim - to study endocrine-immune factors in pregnant women with HPD and the threat of abortion in the first trimester of pregnancy. Materials and methods. 64 pregnant women of reproductive age with HPD (uterine leiomyoma and adenomyosis) against the background of the threat of early abortion and past IDIGO before pregnancy (main group) were examined. The control group consisted of 30 pregnant women without HPD and no history of IDIGO. The cytokine profile was studied in the blood serum of pregnant women - TNFα, IFNγ, IL-8, IL-6, IL-4, the content of progesterone, prolactin and cortisol. Results. In the first trimester of pregnancy, the average progesterone level in the main group was 13% lower than in the control group, which indicated a pronounced insufficiency of the function of the corpus luteum of pregnancy. An increase in cortisol and prolactin levels was also found, almost twice as high as in the control group (p<0.05). The TNFα/IL-4 ratio was almost 3 times higher than in the control group, and the IFNγ/IL-4 ratio was almost 2 times higher. IL-8 was increased in the main group almost twice as high, and IL-6 by 25.5% (p<0.05). Conclusions. An increase in proinflammatory cytokines in pregnant women with HPD against the background of the threat of early abortion may indicate a shift in the cytokine profile in this pathology of pregnancy towards the inflammatory type and indicates a long course of IDIGO before pregnancy. Increased cortisol and prolactin may indicate a strain on the stress-realizing link of adaptive reactions in the conditions of martial law in Ukraine and may contribute to the threat of early abortion. The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research. The authors declare that there is no conflict of interest.