The T-helper 1/T-helper 2 balance in peripheral blood of women with hyperemesis gravidarum

Objective: The purpose of this study was to evaluate the T-helper 1/T-helper 2 balance and its relation with pregnancy-related hormones in hyperemesis gravidarum. Study Design: The T-helper 1/T-helper 2 ratio and plasma progesterone and estrogen levels were examined in the peripheral blood of 22 women with hyperemesis gravidarum and normal pregnancies. The proportion of CD4-positive cells that expressed intracellular cytokines (interferon gamma and interleukin-4) were analyzed by blood flow cytometry. The ratio of interferon gamma–secreting cells to interleukin-4–secreting cells was taken as the T-helper 1/T-helper 2 ratio. Results: In hyperemesis gravidarum, the proportions of interleukin-4–secreting cells increased, and the T-helper 1/T-helper 2 ratio averaged 8.4 ± 0.9, which was significantly lower than in normal pregnancy (11.6 ± 1.1, P< .05). The changes in the T-helper 1/T-helper 2 ratio in hyperemesis gravidarum were accompanied by the elevation of progesterone and estrogen levels. Conclusion: A further shift of the T-helper 1/T-helper 2 balance to the T-helper 2 dominance in hyperemesis gravidarum may be related to the increase of progesterone and estrogen levels. (Am J Obstet Gynecol 2002;187:1631-5.)