Assessment of Interleukin-6, Tumor Necrosis Factor-Α and C-Reactive Protein in Preeclamptic Women in Nasarawa State Nigeria

Abstract

Background: Pre-eclampsia is a life-threatening high blood pressure disorder which usually develops after 20 weeks of pregnancy affecting both the mother and the unborn child. Globally, it is estimated that over 70,000 maternal deaths and 500,00 fetal deaths occur annually due to preeclampsia. Majority of these deaths are recorded in low and middle-income countries. Objective: This study focused on the assessment of the levels of inflammatory cytokines (Interleukin-6, Tumor Necrosis Factor-α and C-Reactive Protein) among preeclamptic women in Nasarawa State and to determine the relationship between these markers and the onset of preeclampsia. Study Design: The current study was a cross-sectional study. Place and Duration of Study: This study was carried out in selected hospitals in Nasarawa State, Nigeria from June 2024 to September 2024. Methodology: Fifty two blood samples were collected from preeclamptic women and normotensive controls into Ethylene Diamine Tetraacetic Acid (EDTA) tubes, spun at 3000 rpm for 10 minutes before collecting the plasma into labeled tubes and stored at -20oC until ready for analysis. The preeclamptic women ≤34 weeks pregnant were selected based on having blood pressure of 140/90, having protein in their urine, and reside within the study area. The control group were normotensive, without proteinuria. Interleukin-6, Tumor Necrosis Factor-α and C-Reactive Protein were estimated using ELISA method. Urine samples were also collected from both groups for protein detection using dipstick method. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSSv23.0). Continuous variables were reported as mean ± SD, with comparison using the independent t- test and correlations assessed with the Pearson/Spearman coefficients (P<0.05). Results: There were significantly elevated levels of all three inflammatory markers in the preeclamptic group. Mean IL-6 levels were 48.7 ± 12.3 pg/mL in preeclamptic women versus 18.2 ± 5.6 pg/mL in controls (P< 0.05). Similarly, TNF-α levels were 35.4 ± 10.7 pg/mL in preeclamptic women compared to 16.9 ± 4.8 pg/mL in normotensive women (P< 0.05). CRP levels were also markedly higher in the preeclamptic group 16.2 ± 5.9 mg/L than in controls 5.7 ± 2.4 mg/L (P< 0.05). Correlation analyses revealed strong positive associations between CRP and IL-6 (r = 0.68, P< 0.05) and between CRP and TNF-α (r = 0.61, P< 0.05). Conclusion: This study revealed elevated levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) among the study participants. There is need to include the estimation of these inflammatory markers in routine antenatal test in addition to existing test especially among women most at risk of preeclampsia.