**5. Discussion**

**Figure 3.** Correlation IL-10/platelets.

**Figure 2.** Correlation IL-10/creatinine: r = 0.134 and p = 0.355.

152 Autoantibodies and Cytokines

This study demonstrates differences in IL-10 levels in women with preeclampsia compared to the levels in women with a normal pregnancy outcome.

We found that in pregnant women with preeclampsia the increased serum concentrations of IL-10 predicted lower likelihood for the development of severe preeclampsia.

Longitudinal studies in mice demonstrate a sequential change in the cytokine profile in serum including interleukin 10 in peripheral blood and release from spleen elements as pregnancy advances.

In the second half of pregnancy, IL-10 inhibition in mice is related with fetal growth retardation [16]. Progesterone has been shown to increase Th2-type responses in T cells [17]. This study demonstrated that there is a significant alteration in the serum concentration of lL-10 in severe preeclampsia compared with normal pregnancy and in moderate preeclampsia groups of patients.

The regression analysis applied in this study showed diastolic blood pressure of 100 mmHg or higher, systolic blood pressure of 160 mmHg or higher, persistent proteinuria in pregnancy, the serum LDH concentration of 450 U/L or higher, and reduced serum concentrations of IL-10 in maternal serum as significant predictors of severe preeclampsia. While other variables predicted the development of severe preeclampsia, IL-10 decreased such likelihood. IL-10 was also found to be negatively correlated with proteinuria and positively correlated with blood platelets. Significantly higher concentration of IL-10 was confirmed in patients with higher number of platelets in the blood. The serum concentration of IL-10 was significantly lower in patients with higher amount of proteins in the urine.

This study demonstrated platelet count and proteinuria as significant predictors of serum IL-10 concentration—urine proteins predicting lower serum IL-10 while platelets count predicting higher serum concentration of interleukin 10.

Other studies suggest a proportional link between the level of proteinuria and adverse clinical outcomes. In recent study 13,000 pregnant women found significant proteinuria, defined as 21 or more on dipstick analysis, and it was associated with an increase in prematurity rates, intrauterine fetal growth restriction, and increased neonatal morbidity and mortality when associated with hypertension [18]. Other studies suggest that it is the presence of proteinuria rather than the severity, which is associated with poorer outcomes in these complications for mother and stillbirth. There is evidence that even the finding of trace proteinuria in pregnant women with hypertension is associated with an increase in adverse outcomes.

Taking into consideration changes of anti-inflammatory cytokine concentrations in severe preeclampsia, the moderate phase can be analyzed as a critical stage in complicated pregnancy.
