Maternal, placental and cord blood cytokines and the risk of adverse birth outcomes among pregnant women infected with Schistosoma japonicum in the Philippines

Background The objectives of this study were to 1) evaluate the influence of treatment with praziquantelon the inflammatory milieu in maternal, placental, and cord blood, 2) assess the extent to which proinflammatory signatures in placentaland cord bloodimpacts birth outcomes, and 3) evaluate the impact of other helminths on the inflammatory micro environment. Methods/Findings This was a secondary analysis of samples from 369 mother-infant pairs participating in a randomized controlled trial of praziquantelgiven at 12–16 weeks’ gestation. We performed regression analysis to address our study objectives. In maternal peripheral blood, the concentrations of CXCL8, and TNF receptor I and II decreased from 12 to 32 weeks’ gestation, while IL-13 increased. Praziquanteltreatment did not significantly alter the trajectory of the concentration of any of the cytokines examined. Hookworm infection was associated with elevated placentalIL-1, CXCL8 and IFN-γ. The risk of small-for- gestational ageincreased with elevated IL-6, IL-10, and CXCL8 in cord blood. The risk of prematurity was increased when cord bloodsTNFRI and placentalIL-5 were elevated. Conclusions Our study suggests that fetal cytokines, which may be related to infectious disease exposures, contribute to poor intrauterine growth. Additionally, hookworm infection influences cytokine concentrations at the maternal-fetal interface. Clinical Trial Registry number and website ClinicalTrials.gov (NCT00486863).