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Published on: October 10, 2025
Regulatory Cytokine Expression and Preterm Birth: Case-Control Study Nested in a Cohort
Thaís Basso de Brito Pereira1, Erika Barbara Abreu Fonseca Thomaz2, Flávia Raquel Fernandes do Nascimento3
1Graduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
Low levels of regulatory cytokine expression, specifically Interleukin-10 (IL-10) and Transforming Growth Factor β (TGF-β), are significant risk factors for preterm birth (PTB). Bacterial vaginosis (BV) was not found to be associated with PTB in this study.
Area of Science:
- Reproductive immunology
- Maternal-fetal medicine
- Immunology of pregnancy
Background:
- Established preterm birth (PTB) risk factors explain limited cases.
- Previous PTB is a strong predictor, but unavailable for primiparous women.
- Conflicting evidence exists on regulatory cytokine expression (RCE) and PTB.
Purpose of the Study:
- Investigate the association between RCE (IL-10, TGF-β) and PTB.
- Assess the role of bacterial vaginosis (BV) in this relationship.
Main Methods:
- Case-control study nested within the BRISA prospective cohort.
- Recruited pregnant women (22-25 weeks gestation) in São Luís, Brazil.
- Measured serum IL-10 and TGF-β; diagnosed BV via Nugent score/clue cells; PTB defined by ultrasound.
Main Results:
- 327 women included (109 cases, 218 controls).
- No association found between BV and PTB.
- Low IL-10 (OR=2.92) and TGF-β (OR=16.90) levels, and low levels of both (OR=77.16), significantly increased PTB odds.
Conclusions:
- Decreased RCE (low IL-10/TGF-β) is a PTB risk factor, independent of BV.
- Low IL-10/TGF-β levels at 22-25 weeks may serve as early PTB predictors.
- Monitoring RCE is recommended, particularly for primiparous women.
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