Identifying the timing and type of inflammatory markers for potential prediction of preeclampsia in women with obesity.

Background: Preeclampsia is a leading contributor to maternal and infant mortality, and early risk identification is a high priority. Inflammatory markers have shown potential as biomarkers for preeclampsia prediction, though optimal timing and marker selection remain unclear.

Methods: We measured 20 inflammatory markers using the Luminex platform across all three trimesters in 37 participants who developed preeclampsia and 74 normotensive controls, matched for pre-pregnancy body mass index (>25), smoking status, and race. We examined individual markers by trimester, changes in marker levels between trimesters, and ratios of pro- to anti-inflammatory markers, adjusting analyses for maternal age, gestational age, and fetal sex.

Results: First-trimester levels of proinflammatory cytokines (GM-CSF, IFN-α, IFN-γ, IL-1α, IL-1β, IL-8, IL-12p70, IL-17a, TNF-α) and anti-inflammatory cytokines (IL-4, IL-10, and IL-13) were strongly associated with preeclampsia (standardized odds ratios > 2). First-trimester pro-anti-inflammatory ratios (e.g. TNF-α:IL-10 and IFN-γ:IL-10) also correlated with preeclampsia. Changes in inflammatory markers across trimesters and interactions with fetal sex were not significant.

Conclusion: Our results suggest that the first trimester inflammatory markers and ratios may offer utility for preeclampsia prediction. Future research should explore these associations in diverse populations and validate their clinical utility. Early risk identification can inform interventions to prevent preeclampsia and improve perinatal outcomes.