Endocrine immune interactions in human parturition

Abstract

Human parturition is an inflammatory event, modulated and influenced by a host of other environmental and physiological processes, including the endocrine hormones.Complex bidirectional communication occurs between the two systems to bring about some of the changes that are seen in labour, an event that is not yet fully understood.Preterm birth is a major problem in obstetrics and neonatology, with dysfunctional labour or prolonged pregnancy also making increasingly significant contributions to maternal morbidity. With better understanding of normal and abnormal parturition we may be able to develop novel ways of treating these complications of pregnancy and reduce maternal and neonatal morbidity and mortality. This review discusses the crucial role that endocrine-immune interaction plays in the process of labour and in the processes of abnormal and preterm labour. We propose that amongst these complex interactions it is the immune system that is the driving force behind human parturition. Keywords Parturition Endocrine InflammationImmune

A comparison of heart rate variability in women at the third trimester of pregnancy and during low-risk labour

“…In this regard, the weaker anticorrelations of the maternal IBI fluctuations at labour (L-NC vs. P) could then reflect the participation of such anti-inflammatory autonomic pathway. This consideration is in accordance with the particular conceptualization of labour as an inflammatory event, either driven by exogenous or endogenous stimuli [7,28,33,34]. This position is supported by evidence identifying that some important labour processes, such as cervix remodelling, rupture of membranes, and rhythmic contractions, appear to be mediated by inflammatory processes [34].…”

“…The details of how these haemodynamic changes are driven by autonomic adaptations and, moreover, the actual role of the autonomic nervous system (ANS) during pregnancy remain to be fully elucidated [6]. In this regard, several findings prompt to consider labour as an inflammatory event that is not only initiated by hormonal factors [7]. In consequence, it can be assumed that labour may also introduce an anti-inflammatory response carried out by the autonomic activity [8].…”

Regulation of GTP-binding Protein (Gαs) Expression in Human Myometrial Cells

“…QNZ-A number of proinflammatory cytokines, including TNF, are associated with the onset of both normal and preterm birth (23,24). Taken together with data highlighting the reduction of G␣ s protein levels in term and preterm laboring myometrium, we speculate that the localized inflammation within the myometrium is an important step in this transition from quiescence to contractility.…”

CXCR3 Polymorphism and Expression Associate with Spontaneous Preterm Birth

“…According to the current proposal, the choriodecidua transmits signals required for the activation of labor-producing uterine contractions. Likewise, fetal membranes overlying the internal orifice of the cervix could potentially transmit signals for cervical ripening (70).…”