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Flow mediated vasodilation and circulating concentrations of high sensitive C-reactive protein, interleukin-6 and tumor necrosis factor-α in normal pregnancy – The Cardiovascular Risk in Young Finns Study


Heli Saarelainen, Department of Obstetrics and Gynecology, Kuopio University Hospital, Puijonlaaksontie 2, PO box 1777, FIN-70211
Kuopio, Finland


Background:  Traditional risk factors such as hyperlipidemia induce a state of inflammation that impairs vascular function. Despite marked maternal hyperlipidemia, endothelial function improves during pregnancy. In non-pregnant state increased circulating levels of pro-inflammatory cytokines and high sensitive C-reactive protein (hsCRP) lead to attenuated flow mediated vasodilation. Relation between endothelial function and pro-inflammatory cytokines has not been studied thoroughly in pregnancy. The aim of this study was to evaluate the effect of pregnancy on hsCRP and pro-inflammatory cytokines and their associations with vascular endothelial function.

Methods:  As part of population-based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland we measured brachial artery flow mediated dilation (FMD) and serum concentrations of hsCRP, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in 57 pregnant Finnish women throughout gestation and 62 control women matched for age and smoking.

Results:  HsCRP-concentration was greater in pregnancy compared to non-pregnant controls (median hsCRP 2·52 mg l−1 versus 1·21 mg l−1, P<0·001). IL-6-concentration was slightly increased in pregnancy compared with the non-pregnant controls (median 1·66 versus 1·32 mg l−1, non-significant [NS]) and TNF-α-concentration was slightly decreased in pregnant group (2·11 versus 2·38 pg ml−1, NS). FMD increased during pregnancy and IL-6 had a positive correlation to the FMD in pregnancy (= 0·288, = 0·031).

Conclusions:  Improvement of FMD in normal pregnancy was not affected by increase in hsCRP concentration. We found an association with IL-6 and FMD but we believe that improvement in endothelial function during normal pregnancy is not caused by variation in hsCRP, IL-6 or TNF-α.