PREDICTIVE RELEVANCE OF IL-10/TNFα RATIO FOR EARLY PREGNANCY LOSS

Abstract

Pregnancy requires finely tuned maternal immune adaptations to tolerate the semi-allogeneic fetus while maintaining protection against infection. Among key mediators, interleukin-10 (IL-10) supports immune tolerance and suppresses excessive inflammation, whereas tumor necrosis factor-alpha (TNFα) promotes pro-inflammatory responses. To evaluate the dynamics of IL-10 and TNFα during early pregnancy and to assess the clinical value of the IL-10/TNFα ratio as a potential indicator of pregnancy outcome, including the influence of advanced maternal age.A prospective observational study was conducted in 2023–2024 at a tertiary obstetric center in Tashkent. A total of 98 pregnant women were included: 76 women with a history of prior pregnancy loss and 22 healthy pregnant women. Serum IL-10 and TNFα levels were assessed during the first trimester using immunoassay methods. In pregnancies complicated by early loss, IL-10 failed to rise and showed a downward trend, while TNFα increased relative to controls. At 6–8 weeks, mean IL-10 was 2.66 ± 0.81 pg/mL in controls versus 2.21 ± 0.74 pg/mL in the study group (p<0.05), whereas TNFα was 5.33 ± 1.40 pg/mL versus 6.11 ± 1.44 pg/mL, respectively (p<0.05). The IL-10/TNFα ratio at 6–8 weeks was lower in the study group (0.37 ± 0.12) compared with controls (0.52 ± 0.18, p<0.01). The IL-10/TNFα ratio reflects the balance between immune tolerance and inflammation in early pregnancy and may serve as a practical immunological indicator for identifying women at increased risk of adverse outcomes, particularly among older mothers and those with prior pregnancy losses.