Chemokines profile as early predictor for complicated pregnancy among primigravida at high-risk of toxoplasmosis

Abstract

Background: Serum chemokines have variable functions related to angiogenesis that might be implicatedin adverse pregnancy outcomes. Their assessment in toxoplasmosis during antenatal care will reduce fetaland neonatal morbidity.Objective: To evaluate the distinguishing ability of chemokines in predicting the outcome of toxoplasmosisand its-related pregnancy complications in vulnerable primigravida.Patients and Methods: The study included three groups of pregnant women; 60 high risk primigravida(A), 60 low risk primigravida (B) for criteria for toxoplasmosis, and 60 multigravida (C) who had a historyof toxoplasmosis-related pregnancy complications. Blood samples were obtained to assess seropositivityfor anti-T. gondii Igs, M and G and for ELISA estimation of interleukin-6 (IL-6), C-X-C chemokine-ligand-9(CXCL9), chemotactic-competent motif ligand-2, and -5 (CCL2 and CCL5). Ability of the estimatedparameters to predict the reported pregnancy complications was evaluated.Results: In group A, the number of positive samples was higher and showed significantly higher CXCL9levels than group B samples. In seropositive patients, CCL2 and 5 levels were significantly higher in group < br />A, while in group B samples, only serum CCL2 levels were significantly higher. In addition, CCL2 levelswere higher in IgG or IgG/IgM of group B than in group A subjects. Serum IL-6 levels were significantlyhigher in seropositive than seronegative women and in IgM than in IgG or IgG/IgM samples of both Aand B groups. In group C with pregnancy complications, especially spontaneous abortion (SA), earlypregnancy loss (EPL) and preterm labor were the most frequently encountered complications. Pregnancycomplications were significantly frequent among group A women. While high CXCL9 levels alone couldpredict pregnancy complications, high IL-6 levels could predict seropositivity, and seropositivity mightpredict SA or EPL.Conclusion: Serum CXCL9 and CCL2 levels could distinguish women vulnerable to developing pregnancycomplications. High CXCL9 levels could predict SA or EPL, while coupled with high IL-6 levels it coulddistinguish seropositivity in primigravida.