# Postpartum cytokine shifts and IL-10–mediated immune suppression in malaria-infected primigravid women

## TL;DR

This study finds that high levels of IL-10 in pregnant women at delivery are linked to increased malaria risk after childbirth in malaria-endemic areas.

## Contribution

The novel contribution is identifying IL-10 as a key cytokine associated with postpartum malaria susceptibility in primigravid women in Sub-Saharan Africa.

## Key findings

- Malaria-infected women had significantly higher IL-10 levels and lower IL-6:IL-10 ratios at delivery.
- Elevated IL-10 levels strongly correlated with postpartum malaria infection.
- IL-4 also showed significant effects, indicating complex immune regulation.

## Abstract

According to the World Health Organization’s recent report, malaria remains a major health challenge during pregnancy and for postpartum women in endemic regions. While immune alterations during pregnancy are well characterized, postpartum cytokine dynamics and their impact on malaria susceptibility remain poorly defined. This study uniquely investigates how cytokine balance shifts, contribute to malaria susceptibility in primigravid women during the postpartum period.

A total of 33 Burkinabè women were enrolled at delivery and followed up at 1 and 3 months postpartum. Plasma cytokine concentrations (IL-4, IL-6, IL-10, TNF-α, IFN-γ) were quantified by ELISA. Malaria infection was detected by PCR and microscopy. Statistical analyses included effect size calculations and cluster analyses to assess immune profiles.

At delivery, 48.5% of women tested positive for malaria by PCR. Malaria-infected women had significantly elevated IL-10 levels and a decreased IL-6:IL-10 ratio compared with non-infected women (p = 0.005). This anti-inflammatory shift persisted into the early postpartum period. Strong correlations were observed between IL-10 levels and malaria infection (σ = 0.9, p < 0.001). Of note, IL-4 also showed a significant effect, highlighting a complex immunoregulatory environment.

Our findings reveal, for the first time in a Sub-Saharan primigravid cohort, that an IL-10-dominant cytokine profile at delivery is strongly associated with postpartum malaria susceptibility. Modulating cytokine responses could represent a novel therapeutic approach to improving maternal health in malaria-endemic regions.