title: Do uterine natural killer cell numbers in peri-implantation endometrium predict hypertensive disorder in pregnancy in women with a history of reproductive failure?
abstract: The aim of this study was to investigate whether or not increased uterine natural killer (uNK) cell numbers in the peri-implantation endometrium are associated with an increased risk of hypertensive disorders in a subsequent pregnancy. This is a retrospective study including 80 women with a history of unexplained recurrent miscarriage or recurrent implantation failure. Precisely timed endometrial biopsies were obtained from women 7-9 days after the luteinising hormone surge. uNK cells were immunostained for CD56+ and expressed as a percentage of total stromal cells. Patients were defined as having a high uNK cell count if the percentage of total stromal cells was more than 13.9%. Five out of 29 (17.2%) women in the high uNK cell count group and 5 out of 51 (9.8%) women in the normal uNK cell count group developed gestational hypertension. Pre-eclampsia was diagnosed in 2 (6.9%) patients in the high uNK cell count group and 1 (2.0%) patient from the normal uNK cell count group. There was no significant difference in the incidence of either gestational hypertension (P=0.483) and pre-eclampsia (P=0.296) between groups. The overall incidence of hypertensive disease in women with high uNK cell count (24.1%) was two times higher than women with normal uNK cell count (11.8%), but it was not statistically significant (P=0.208). An increased uNK cells count in the peri-implantation period in a cycle prior to conception did not appear to significantly increase the likelihood of hypertensive disease of pregnancy.
authors.affiliation: Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, Jessop Wing, Sheffield Teaching Hospitals, Tree Root Walk, Sheffield S10 2SF, UK.
authors.forename: Alice Wai Yee
authors.initials: AW
authors.lastname: Wong
authors.affiliation: Biomedical Research Centre, Sheffield Hallam University, City Campus, Sheffield S1 1WB, UK.
authors.forename: Bethan
authors.initials: B
authors.lastname: Archer
authors.affiliation: Biomedical Research Centre, Sheffield Hallam University, City Campus, Sheffield S1 1WB, UK.
authors.forename: Najat
authors.initials: N
authors.lastname: Mariee
authors.affiliation: Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, Jessop Wing, Sheffield Teaching Hospitals, Tree Root Walk, Sheffield S10 2SF, UK.
authors.forename: Tin Chiu
authors.initials: TC
authors.lastname: Li
authors.affiliation: Biomedical Research Centre, Sheffield Hallam University, City Campus, Sheffield S1 1WB, UK. Electronic address: S.M.Laird@shu.ac.uk.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Laird
mesh_terms: D000026:Abortion, Habitual; D000328:Adult; D001706:Biopsy; D019002:CD56 Antigen / Q000032:analysis; D010064:Embryo Implantation; D004717:Endometrium / Q000166:cytology* / Q000276:immunology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007694:Killer Cells, Natural / Q000166:cytology*; D018655:Lymphocyte Count; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D014599:Uterus / Q000166:cytology* / Q000276:immunology / Q000473:pathology
chemical_list: D019002:CD56 Antigen; C522918:NCAM1 protein, human
keywords: Gestational hypertension; Pre-eclampsia; Recurrent implantation failure; Recurrent miscarriage; Uterine natural killer cell