Plasma tumor necrosis factor-alpha soluble receptor p55 (sTNFp55) concentrations in eclamptic, preeclamptic and normotensive pregnant Zimbabwean women

We sought to examine the relationship between excessive tumor necrosis fact or-alpha (TNF-alpha) release las measured by sTNFp55 plasma concentrations) and risk of eclampsia and preeclampsia, respectively, among sub-Saharan Af rican women delivering at Harare Maternity Hospital, Zimbabwe. In total, 33 pregnant women with eclampsia, 138 women with preeclampsia and 185 normote nsive women were included in a case-control study conducted during the peri od, June 1995 through April 1996. Postpartum plasma sTNFp55 was measured by enzyme linked immunosorbent assay. Women with eclampsia had significantly higher sTNFp55 than normotensive controls (1.87 vs 1.35 ng/ml, P < 0.001). Similarly, women with preeclampsia had sTNFp55 concentrations higher than n ormotensive controls (1.69 vs 1.35 ng/ml, P < 0.001). The odds ratio for ec lampsia was 5.00 (adjusted odds ratio (OR) 5.00, 95% confidence interval (C I) 1.20-20.92) among women in the highest quartile of the control sTNFp55 d istribution compared with women in the lowest quartile. The corresponding o dds ratio and 95% CI for preeclampsia was 2.37 (1.11-5.06). Postpartum plas ma sTNFp55 concentrations are increased among Zimbabwean women with eclamps ia and preeclampsia as compared with their normotensive counterparts. These findings are consistent with the hypothesized role of cytokines in mediati ng endothelial dysfunction and the pathogenesis of preeclampsia/eclampsia. Additional work is needed to identify modifiable risk factors for the exces sive synthesis and release of TNF-c( in pregnancy; and to assess whether me asurements of sTNFp55 early in pregnancy may be used to identify women like ly to benefit from anti-inflammatory therapy. (C) 1998 Elsevier Science Ire land Ltd. All rights reserved.