1887
1 - The 3rd Annual International Conference on Information and Sciences
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Preterm birth has a significant impact on neonatal health and the healthcare system as it increases neonatal morbidities and mortality rates. Interleukin-6 is one of the pro-inflammatory cytokines that can trigger the production of chemokines and uterine activation proteins, consequently causing uterine contraction and subsequent cervical change. Hypoxia-inducible factor-1α plays a pivotal role in the hypoxic adaptive response of tissues. It has been suggested that hypoxia has a vital role in the initiating and/or strengthening of uterine contractions, proposing that hypoxia-inducible factor-1α could be involved in this process.

Investigate whether serum concentrations of interleukin-6 and hypoxia-inducible factor-1α would differ between women with threatened preterm labor who deliver prematurely and those who continue their pregnancy till term.

The case-control study was extended over 12 months, including women in their 28th to 35th weeks of gestation and with a single viable fetus. The women were divided into three groups: women with threatened preterm labor who delivered prematurely (27 women), women with threatened preterm labor who continued their pregnancy till term (23 women), and women with matching gestational age and uncomplicated pregnancies (the controls = 40 women). The serum levels of interleukin-6 and hypoxia-inducible factor-1α were measured by Enzyme-linked immunosorbent assay.

The mean values of interleukin-6 and hypoxia-inducible factor-1α were significantly different between the study groups (p-value <0.001 by one-way ANOVA), where women with threatened preterm labor who delivered prematurely had higher serum values of interleukin-6 and hypoxia-inducible factor-1α (124.5 and 102.4, respectively) than the women with threatened preterm labor who continued their pregnancy till term (71.0 and 55.2, respectively), and than the women in the control group (55.3 and 50.0, respectively). There was a significant negative statistical correlation between the values of interleukin-6 and hypoxia-inducible factor-1α and the timing of delivery (R = -0.786 and -0.644, respectively, p-value < 0.001).

Both interleukin-6 and hypoxia-inducible factor-1α serum concentrations can help differentiate pregnant women who are genuinely in preterm labor from those who have preterm contractions but are not at risk of imminent delivery.

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2024-02-08
2024-07-11
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References

  1. Edmonds DK, Lees C, Bourne TH. In: Dewhurst’s Textbook of Obstetrics & Gynaecology. Hoboken, NJ: Wiley; 2018. p. 399–424.
    [Google Scholar]
  2. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016 Oct; 128:(4):e155-64. doi: 10.1097/AOG.0000000000001711.
    [Google Scholar]
  3. Rundell K, Panchal B. Preterm Labor: Prevention and Management. Am Fam Physician. 2017 Mar 15; 95:(6):366-372.
    [Google Scholar]
  4. Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019 Jan; 7:(1):e37-e46. doi: 10.1016/S2214-109X(18)30451-0.
    [Google Scholar]
  5. Jehan F, Sazawal S, Baqui AH, Nisar MI, Dhingra U, Khanam R, et al. Multiomics Characterization of Preterm Birth in Low- and Middle-Income Countries. JAMA Netw Open. 2020 Dec 1; 3:(12):e2029655. doi: 10.1001/jamanetworkopen.2020.29655.
    [Google Scholar]
  6. Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, et al. Born Too Soon Preterm Birth Action Group. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013; 10 Suppl 1:(Suppl 1):S2. doi: 10.1186/1742-4755-10-S1-S2.
    [Google Scholar]
  7. Manuck TA. Racial and ethnic differences in preterm birth: A complex, multifactorial problem. Semin Perinatol. 2017 Dec; 41:(8):511-518. doi: 10.1053/j.semperi.2017.08.010.
    [Google Scholar]
  8. Wolke D, Eryigit-Madzwamuse S, Gutbrod T. Very preterm/very low birthweight infants’ attachment: infant and maternal characteristics. Arch Dis Child Fetal Neonatal Ed. 2014 Jan; 99:(1):F70-5. doi: 10.1136/archdischild-2013-303788.
    [Google Scholar]
  9. Verrips G, Brouwer L, Vogels T, Taal E, Drossaert C, Feeny D, et al. Long term follow-up of health-related quality of life in young adults born very preterm or with a very low birth weight. Health Qual Life Outcomes. 2012 May 15; 10::49. doi: 10.1186/1477-7525-10-49.
    [Google Scholar]
  10. Wolke D, Chernova J, Eryigit-Madzwamuse S, Samara M, Zwierzynska K, Petrou S. Self and parent perspectives on health-related quality of life of adolescents born very preterm. J Pediatr. 2013 Oct; 163:(4):1020-6.e2. doi: 10.1016/j.jpeds.2013.04.030.
    [Google Scholar]
  11. Simms V, Gilmore C, Cragg L, Marlow N, Wolke D, Johnson S. Mathematics difficulties in extremely preterm children: evidence of a specific deficit in basic mathematics processing. Pediatr Res. 2013 Feb; 73:(2):236-44. doi: 10.1038/pr.2012.157.
    [Google Scholar]
  12. Blencowe H, Lee AC, Cousens S, Bahalim A, Narwal R, Zhong N, et al. Preterm birth-associated neurodevelopmental impairment estimates at regional and global levels for 2010. Pediatr Res. 2013 Dec; 74 Suppl 1:(Suppl 1):17-34. doi: 10.1038/pr.2013.204.
    [Google Scholar]
  13. Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013 Dec; 74 Suppl 1:(Suppl 1):35-49. doi: 10.1038/pr.2013.205.
    [Google Scholar]
  14. Suman V, Luther EE. Preterm Labor. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536939/
    [Google Scholar]
  15. Prediction and Prevention of Spontaneous Preterm Birth: ACOG Practice Bulletin, Number 234. Obstet Gynecol. 2021 Aug 1; 138:(2):e65-e90. doi: 10.1097/AOG.0000000000004479.
    [Google Scholar]
  16. Manuck TA, Esplin MS, Biggio J, Bukowski R, Parry S, Zhang H, et al. The phenotype of spontaneous preterm birth: application of a clinical phenotyping tool. Am J Obstet Gynecol. 2015 Apr; 212:(4):487.e1-487.e11. doi: 10.1016/j.ajog.2015.02.010.
    [Google Scholar]
  17. Justiz Vaillant AA, Qurie A. Interleukin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499840/
    [Google Scholar]
  18. Rose-John S. Interleukin-6 Family Cytokines. Cold Spring Harb Perspect Biol. 2018 Feb 1; 10:(2):a028415. doi: 10.1101/cshperspect.a028415.
    [Google Scholar]
  19. Kang S, Tanaka T, Narazaki M, Kishimoto T. Targeting Interleukin-6 Signaling in Clinic. Immunity. 2019 Apr 16; 50:(4):1007-1023. doi: 10.1016/j.immuni.2019.03.026.
    [Google Scholar]
  20. Akdis M, Aab A, Altunbulakli C, Azkur K, Costa RA, Crameri R, et al. Interleukins (from IL-1 to IL-38), interferons, transforming growth factor β, and TNF-α: Receptors, functions, and roles in diseases. J Allergy Clin Immunol. 2016 Oct; 138:(4):984-1010. doi: 10.1016/j.jaci.2016.06.033.
    [Google Scholar]
  21. Green ES, Arck PC. Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus. Semin Immunopathol. 2020 Aug; 42:(4):413-429. doi: 10.1007/s00281-020-00807-y.
    [Google Scholar]
  22. Hantoushzadeh S, Anvari Aliabad R, Norooznezhad AH. Antibiotics, Inflammation, and Preterm Labor: A Missed Conclusion. J Inflamm Res. 2020 May 25; 13::245-254. doi: 10.2147/JIR.S248382.
    [Google Scholar]
  23. Singh S, Dey M, Singh S, Sasidharan S. Biochemical Markers As Predictor Of Preterm Labor-Their Clinical Relevance And The Current Status. Gynecol Obstet Reprod Med. 2022; 28:(3):282-9. doi: 10.21613/GORM.2020.1108.
    [Google Scholar]
  24. Huang LE, Bunn HF. Hypoxia-inducible factor and its biomedical relevance. J Biol Chem. 2003 May 30; 278:(22):19575-8. doi: 10.1074/jbc.R200030200.
    [Google Scholar]
  25. Zaramella P, Vanzo V, Cardin R, Piciocchi M, Zambon A, Parata F, Priante E, Chiarelli S, Baraldi E. Hypoxia-Inducible Factor in cord blood of term and preterm newborns. J Ped Moth Care. 2017; 2:(2):1-7.
    [Google Scholar]
  26. Tianthong W, Phupong V. Serum hypoxia-inducible factor-1α and uterine artery Doppler ultrasound during the first trimester for prediction of pre-eclampsia. Scientific Reports. 2021 Mar 23; 11:(1):1-7. doi: 10.1038/s41598-021-86073-w.
    [Google Scholar]
  27. Sezer SD, Küçük M, Nergiz Avcio-lu S, Zafer E, Altinkaya SÖ, Biçakçi B, et al. Comparison of maternal and umbilical cord blood HIF-1 α and nitric oxide levels in early and late onset preeclamptic pregnancies. Gynecol. Endocrinol. 2015; 31::945–948. doi: 10.3109/09513590.2015.1065483.
    [Google Scholar]
  28. Glover AV, Manuck TA. Screening for spontaneous preterm birth and resultant therapies to reduce neonatal morbidity and mortality: A review. Semin Fetal Neonatal Med. 2018 Apr; 23:(2):126-132. doi: 10.1016/j.siny.2017.11.007.
    [Google Scholar]
  29. Rose-John S. The soluble interleukin-6 receptor and related proteins. Best Pract Res Clin Endocrinol Metab. 2015 Oct; 29:(5):787-97. doi: 10.1016/j.beem.2015.07.001.
    [Google Scholar]
  30. Chiesa C, Pacifico L, Natale F, Hofer N, Osborn JF, Resch B. Fetal and early neonatal interleukin-6 response. Cytokine. 2015 Nov; 76:(1):1-12. doi: 10.1016/j.cyto.2015.03.015.
    [Google Scholar]
  31. Iriyama T, Wang W, Parchim NF, Song A, Blackwell SC, Sibai BM, et al. Hypoxia-independent upregulation of placental hypoxia inducible factor-1α gene expression contributes to the pathogenesis of preeclampsia. Hypertension. 2015 Jun; 65:(6):1307-15. doi: 10.1161/HYPERTENSIONAHA.115.05314.
    [Google Scholar]
  32. Rath G, Aggarwal R, Jawanjal P, Tripathi R, Batra A. HIF-1 Alpha and Placental Growth Factor in Pregnancies Complicated With Preeclampsia: A Qualitative and Quantitative Analysis. J Clin Lab Anal. 2016 Jan; 30:(1):75-83. doi: 10.1002/jcla.21819.
    [Google Scholar]
  33. Fang Y, Yu S, Ma Y, Sun P, Ma D, Ji C, et al. Association of Dll4/notch and HIF-1a -VEGF signaling in the angiogenesis of missed abortion. PLoS One. 2013 Aug 9; 8:(8):e70667. doi: 10.1371/journal.pone.0070667.
    [Google Scholar]
  34. Zhu LJ, Chen YP, Chen BJ, Mei XH. Changes in reactive oxygen species, superoxide dismutase, and hypoxia-inducible factor-1α levels in missed abortion. Int J Clin Exp Med. 2014 Aug 15; 7:(8):2179-84.
    [Google Scholar]
  35. Oskovi Kaplan ZA, Ozgu-Erdinc AS. Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview. J Pregnancy. 2018 Oct 10; 2018::8367571. doi: 10.1155/2018/8367571.
    [Google Scholar]
  36. Akkaya Fırat A, Alıcı Davutoğlu E, Özel A, Güngör ZB, Madazlı R, Ulakoğlu Zengin E. Hypoxia-inducible factor-1α, hepcidin and interleukin-6 levels in pregnancies with preterm labour. J Obstet Gynaecol. 2020 Aug; 40:(6):813-819. doi: 10.1080/01443615.2019.1672141.
    [Google Scholar]
  37. Herrera-Muñoz A, Fernández-Alonso AM, Fischer-Suárez N, Chedraui P, Pérez-López FR. Maternal serum cytokine levels in pregnancies complicated with threatened preterm labour. Gynecol Endocrinol. 2017 May; 33:(5):408-412. doi: 10.1080/09513590.2017.1284786.
    [Google Scholar]
  38. Öz M, Polat B, Özgü E, Seçkin KD, Taşin C, Danişman N. Interleukin-6 and C-reactive protein levels in the amniotic fluid as indicators of preterm delivery in Turkish women. Clin Exp Obstet Gynecol. 2015; 42:(6):801-4.
    [Google Scholar]
  39. Kim A, Lee ES, Shin JC, Kim HY. Identification of biomarkers for preterm delivery in mid-trimester amniotic fluid. Placenta. 2013 Oct; 34:(10):873-8. doi: 10.1016/j.placenta.2013.06.306.
    [Google Scholar]
  40. Alotaibi M, Arrowsmith S, Wray S. Hypoxia-induced force increase (HIFI) is a novel mechanism underlying the strengthening of labor contractions, produced by hypoxic stresses. Proc Natl Acad Sci U S A. 2015 Aug 4; 112:(31):9763-8. doi: 10.1073/pnas.1503497112.
    [Google Scholar]
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