THE DIFFERENCE OF LEVEL INTERLEUKIN 1 (IL-1) AND TUMOR

NECROSIS FACTOR ALPHA (TNF ) BETWEEN PRETERM LABOR

GIVEN MAGNESIUM SULPHATE THERAPY AND THOSE WHO ARE
NOT
Ferri Waluyo Wiwoho Pujojati, Sri Sulityowati, Supriyadi Day Respati
Department of Obstetrics and Gynecology
Faculty of Medicine of Sebelas Maret University / DR. Moewardi Hospital
Surakarta

ABSTRACT

Background: Prematurity causes neonatal mortality and morbidity. Nearly half of

neonatus who are survive will have congenital neurological disability including
cerebral palsy (CP). The incidence of CP and cognitive impairment associated
with periventricular white matter damage, which is often found in infants who are
born before pregnancy of 32 weeks or acquired corticosubcortical abnormalities in
term newborns (Degos V et al .2008). Pro-inflammatory cytokines is known
significantly increased in the amniotic fluid and fetal brain of neonatus with
infection, including local inflammatory response that causes damage to the fetal
brain. Microbial infections in the amniotic fluid can cause premature labor and
result to a fetal infection. Microorganisms produce a product that can trigger
mononuclear cells to produce IL-1 and TNF-, which can increase the
permeability of the blood brain barrier so that the products of microorganisms and
pro-inflammatory cytokines that can enter the brain and cause tissue damage to
the brain's white matter (white matter damage)of fetus. The latest hypothesis
states that the cause of pre-eclampsia is more in focus to the immune response.
Cytokines are regulator of immune substances that involved in the pathogenesis of
pre-eclampsia. Successful pregnancy is a Th2 phenomenon, in which the Th1 /

Th2 shift to a Th2-type response. Type 1 cytokines including interleukin-2,

interferon (IFN) and tumor necrosis factor alpha (TNF-) are occured in preeclampsia caused by inflammation (Mirahmadian et al, 2008). Plasma
concentration of pro-inflammatory cytokines such as tumor necrosis factor alpha
(TNF-) and interleukin 1 (IL-1) in patients with pre-eclampsia compared to
normal pregnant women.
Objective: To determine the differences of level interleukin 1 (IL-1) and Tumor
Necrosis Factor Alpha (TNF ) in preterm labor given magnesium sulfate therapy
and those who are not.
Methods: An observational cross-sectional analytic approach. The independent
variables are the serum levels of IL-1 and TNF-, a dependent variable of
preterm labor given MgSO4 (preeclampsia) and preterm labor who were not given
MgSO4 (premature rupture of membranes). Statistical analysis using t-test.
Results: 40 subjects of this study who qualify inclusion and exclusion criterias
were divided into 2 groups. 20 subjects group of preterm labor were given
MgSO4 and 20 subjects group of preterm labor were not given MgSO4. Obtained
from the t test that the serum levels of IL-1 was lower in the group of preterm
labor given MgSO4 compared to preterm labor who were not given MgSO4 (0:49
+ 0:22 ng / mL versus 0.71 + 0:28 ng / mL, p <0.05). Serum levels of TNF-
appear to be lower in the group of preterm labor given MgSO4, compared to
preterm labor who were not given MgSO4 (2.24 + 0.56 ng / mL versus 2.80 +
0.85 ng / mL, p <0.05).
Conclusion: Levels of serum TNF and IL-1 are lower in preterm labor given
MgSO4 compared to those without MgSO4.
Keywords: Interleukin-1, tumor necrosis factor , Preterm Labor given MgSO4
(preeclampsia), Preterm labor without given MgSO4 (premature rupture of
membranes).