• Qi Shen, Litao Yu, and Hui Zhang.
• Department of Obstetrics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, China.
• Brit J Hosp Med. 2024 Nov 30; 85 (11): 1131-13.

AbstractAims/Background Fetal growth restriction (FGR) is a common clinical disorder in pregnant women. Inflammation and endoplasmic reticulum stress play an important role in the occurrence and development of FGR. The purpose of this study was to explore the expression and significance of endoplasmic reticulum stress and inflammatory response indicators in the serum of pregnant women with FGR. Methods The data of pregnant women admitted to Changzhou Maternal and Child Health Care Hospital from January 2020 to June 2023 were collected and analyzed by propensity score matching (PSM). Pregnant women with FGR were included in the observation group (n = 65), whereas healthy pregnant women admitted to the hospital during the same period were included in the control group (n = 65). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of inflammatory markers such as tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in all the pregnant women recruited in this study. The serum levels of glucose regulatory protein 78 (GRP78) and C/EBP homologous protein (CHOP), which are characteristic indicators of endoplasmic reticulum stress, in the two groups of pregnant women, were also detected and analyzed. A range of parameters concerning fetal growth and development indicators, such as fetal head circumference, abdominal circumference and fetal development index, of the two groups of study subjects were recorded and compared. Analyze the correlation between inflammatory response indicators and endoplasmic reticulum stress factors in pregnant women with FGR and fetal growth and development indicators. Results The serum levels of TNF-α, IL-1β and IL-6 in the observation group were significantly higher than those in the control group (p < 0.001). The serum levels of GRP78 and CHOP in the observation group were significantly higher than those in the control group (p < 0.001). The levels of GRP78 and CHOP in pregnant women with FGR were negatively correlated with fetal head circumference, abdominal circumference, and fetal growth and development index (p < 0.05). Conclusion The serum levels of inflammatory markers such as TNF-α, IL-1β and IL-6 in pregnant women with FGR were abnormally elevated, indicating severe inflammatory response. In addition, endoplasmic reticulum stress was observed in pregnant women with FGR, marked by significantly elevated levels of GRP78 and CHOP. The levels of TNF-α, IL-1β, IL-6, GRP78 and CHOP were negatively correlated with fetal head circumference, abdominal circumference and fetal growth and development index, implying their impacts on the occurrence and development of FGR.

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