Predicting the implementation of late spontaneous abortion based on the analysis of the cytokine status of pregnant women

Objective. Prediction of late spontaneous abortion based on anamnestic and clinical data, as well as analysis of cytokine status at the local and systemic levels in patients with threatening late spontaneous abortion. Materials and methods. In the period 2022—2024, a comprehensive prospective comparative study was conducted, which included 35 patients with clinical manifestations of a threatening spontaneous abortion at gestational age of 10.0—21.6 weeks (the main group) who received non-drug and drug treatment according to clinical recommendations and 32 patients with a physiological course of pregnancy that ended in emergency delivery (the comparison group). The patients of both groups underwent analysis of clinical and anamnestic data, complete laboratory, ultrasound examination and determination of the concentration of cytokines IL-6, IL-8, IL-10 in blood serum and cervical mucus by enzyme immunoassay at gestational age of 10.0—21.6 weeks. Results. Diseases of the gastrointestinal tract, iron deficiency anemia, repeated pregnancy, premature birth and spontaneous abortion are risk factors for the development of late spontaneous abortion, according to anamnestic data. Cytokine status analysis showed an increase in IL-8 content and a decrease in IL-10 concentration in blood serum. When analyzing the ratio of cytokines in cervical mucus and blood serum, it was found that a decrease in the ratios of IL-6 mucus/IL-6 serum and IL-8 mucus/IL-8 serum increases the risk of miscarriage, while a decrease in the ratio of IL-10 mucus/IL-10 serum reduces the risk of pregnancy losses. Conclusion. As a result of the research, it was found that the following factors have the greatest prognostic significance in relation to the risk of developing late spontaneous abortion and an unfavorable pregnancy outcome: a decrease in serum concentrations of the anti-inflammatory cytokine IL-10 to 2.6 pg/ml or less, an increase in serum concentrations of the pro-inflammatory cytokine IL-8 to 24.3 pg/mlml or more. It seems promising to determine the cytokine status in pregnant women with a threatening late spontaneous abortion, especially the levels of IL-10 and IL-8 in the blood serum to predict the outcome of pregnancy.