Umbilical cord prostaglandins in term and preterm parturition

作者：Hong Joon Seok; Romero Roberto^*; Lee Deug Chan; Than Nandor Gabor; Yeo Lami; Chaemsaithong Piya; Ahn Soyeon; Kim Jung Sun; Kim Chong Jai; Kim Yeon Mee

来源：Journal of Maternal-Fetal and Neonatal Medicine, 2016, 29(4): 523-531.

DOI：10.3109/14767058.2015.1011120

• Chorioamnionitis
• eicosanoids
• funisitis
• intra-amniotic inflammation
• microbial invasion of the amniotic cavity
• PGE(2)
• PGF(2)
• preeclampsia
• pregnancy

Objective: Prostaglandins (PGs) are considered the universal mediators of parturition. Amniotic fluid PGE(2) and PGF(2) concentrations increase before the onset of spontaneous labor at term, as well as during labor. This study was conducted to determine if the concentrations of umbilical cord PGE(2) and PGF(2) change with advancing gestational age, spontaneous labor at term, and preterm labor (with and without funisitis).Methods: Umbilical cord (UC) tissue samples were obtained from women (N=158) with singleton pregnancies in the following groups: (1) term deliveries without labor (TNL; n=20); (2) term deliveries with labor (TIL; n=20); (3) spontaneous preterm deliveries (sPTD) with (n=20) and without acute funisitis (n=20); and (4) preeclampsia without labor (n=78). The concentrations of PGs were determined in different locations of the UC. PGE(2) and PGF(2) were measured by specific immunoassays. Non-parametric statistics were used for analysis.Results: (1) In spontaneous preterm deliveries, the median UC PGE(2) concentration was higher in cases with funisitis than in those without funisitis (233.7pg/mu g versus 87.4pg/mu g of total protein, p=0.001); (2) the median UC PGE(2) concentration in sPTD with funisitis was also higher than that obtained from samples who had undergone labor at term (233.7pg/mu g versus 116.1pg/mu g of total protein, p=0.03); (3) the UC PGE(2) and PGF(2) concentration increased as a function of advancing gestational age before 36 weeks (PGE(2): =0.59, p<0.001; PGF(2): =0.39, p=0.01), but not after 36 weeks (PGE(2): =-0.1, p=0.5; PGF(2): =-0.2, p=0.2); (4) the median UC concentrations of PGE(2) and PGF(2) at term was similar in samples obtained from women with and without labor (PGE(2): TNL 133.7pg/mu g versus TIL 116.1pg/mu g of total protein, p=0.9; PGF(2): TNL 8.4pg/mu g versus TIL 8.1pg/mu g of total protein, p=0.7); and (5) there was no correlation between UC PG concentration and gestational age at term pregnancy (PGE(2): =0.01, p=0.9; PGF(2): =0.07, p=0.7).Conclusions: (1) PGE(2) concentrations in the UC are higher in the presence of acute funisitis than in the absence of this lesion; (2) spontaneous labor at term was not associated with a change in the UC concentration of PGE(2) and PGF(2); and (3) the UC concentrations of PGE(2) and PGF(2) increased as a function of gestational age. We propose that UC PGs act as inflammatory mediators generated in the context of fetal systemic inflammation.

• 出版日期2016-2-16
• 单位NIH