Changes in immune activation markers during pregnancy and postpartum

Changes in CD4+ cell levels and other immune parameters have been reported to occur during pregnancy but the timing of these alterations and their rel ationship to changes in immune function have not been well characterized. I n addition, the influence of sociodemographic, obstetric, and other covaria tes on these relationships is largely unknown. We measured three immune act ivation markers, soluble interleukin-2 receptor (sIL-2R(alpha)), soluble CD 8 antigen (sCD8), and neopterin during pregnancy and postpartum in 170 HIV- 1-seronegative women enrolled in the Mothers and Infants Cohort Study. Ante -partum and postpartum changes in these markers were examined using multiva riable longitudinal random effects models. Neopterin levers began to rise w ell before delivery and were in decline by 2 months postpartum. sIL-2R(alph a) and sCD8 levels increased at or near delivery and peaked by 2 months pos tpartum. After adjustment for other variables, the peak in sIL-2R(alpha) wa s greater among women with pre-term than full-term deliveries (P = 0.05). A ll three markers were higher in whiles than non-whites and in 'hard' drug u sers than non-users (P less than or equal to 0.001 for each). After adjustm ent for these and other variables, hepatitis C virus (HCV) seropositivity w as associated with higher levels of sCD8 and neopterin (P less than or equa l to 0.001 for each) but not sIL-2R(alpha) (P = 0.27). These longitudinal d ata indicate that a state of broad immune activation develops at or near de livery. A number of maternal variables appear to influence the magnitude of these changes. (C) 1999 Elsevier Science ireland Ltd. All rights reserved.