Serum tumor necrosis factor alpha levels in preeclamptic and normotensive pregnant women. a comparative study in a semi urban north Indian population

Background: Preeclampsia is a multisystem disorder of pregnancy hypothesized to be due to endothelial cell dysfunction that increases the maternal and fetal morbidity and mortality. Although intensive research has been done, the etiopathogenesis of preeclampsia (PE) remains uncertain. Inflammatory cytokines are thought to be involved in the pathogenesis of preeclampsia.Preeclampsia occurs in two stages. In the first stage there is reduced placental perfusion because of abnormal implantation and development of the placental vasculature. In the second stage there is widespread inflammation resulting in maternal endothelial cell dysfunction. TNF alpha is an inflammatory cytokine expressed by neutrophils, monocytes and macrophages. Material and methods: The present study isa non-randomized prospective case control study comparing the serum levels of TNF alpha in thirty preeclamptic and thirty normotensive pregnant women during third trimester of pregnancy. Preeclamptic women were divided according to severity (BP and level of proteinuria) into mild (n=15) and severe (n=15). TNF alpha estimation was done by ELISA. Results: TNF alpha levels were significantly higher in preeclamptic women compared to normotensive pregnant women (p=0.001). Serum TNF alpha levels were higher in severe preeclampsia than mild preeclampsia (p=0.043). These results suggest that normal pregnancy is a state of mild inflammation which becomes exaggerated in preeclampsia. Conclusion: The levels of TNF alpha are related with severity of preeclampsia. TNF alpha can be used as a predictive marker for preeclampsia.