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Tumor Necrosis Factor-Alpha, Interleukin-6, and Interleukin-10 Levels are Altered in Preeclampsia: A Systematic Review and Meta-Analysis



Sien Yee Lau, Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand.




Published reports testing the association between cytokine levels and preeclampsia are conflicting. This comprehensive systematic review and meta-analysis aimed at testing the association between preeclampsia and maternal circulating tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-10.

Method of study

A systematic literature search of studies reporting maternal circulating TNF-α, IL-6, and IL-10 in women with preeclampsia and normotensive pregnant women was conducted yielding 41, 28, and 12 eligible reports, respectively.


Both mild preeclampsia and severe preeclampsia were associated with elevated TNF-α [mean difference (MD) = 7.34 pg/mL, 95% CI 5.02–9.66 and MD = 7.91 pg/mL, 95% CI 4.72–11.10, respectively] and IL-6 (MD = 61.01 pg/mL, 95% CI 14.24–107.77 and MD = 28.54 pg/mL, 95% CI 15.90–41.17, respectively) in the third trimester. Preeclampsia was also associated with elevated levels of IL-10 (MD = 5.54, 95% CI 0.69–10.38). The systematic review of studies reporting median data was in consensus with the parametric data.


This systematic review and meta-analysis with accompanying summary of non-parametric data shows elevated maternal circulating TNF-α, IL-6, and IL-10 levels in preeclampsia.