The aim of the study was to investigate changes with gestation of fetal plasma tumor necrosis factor alpha (TNF-α) concentration. In a cross-sectional study, enzyme-linked immunoassay was used to measure plasma TNF-α concentration in 40 fetal blood samples obtained by cordocentesis (n = 25), cardio-centesis (n = 5) or at elective caesarean section (n = 10) at 12-38 weeks gestation. The fetal plasma concentration of TNF-α increased from a mean of 13.5 pg/ml at 12 weeks gestation to 37.5 pg/ml at 38 weeks (r= 0.59, p < 0.0001), and was significantly associated with the monocyte count (r = 0.56, p < 0.001). TNF-α is present in the fetal circulation from at least 12 weeks and the changes in plasma TNF-α concentration with gestation coincide with the development of the fetal monocyte-macrophage system.

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