Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus

Green, Ella Shana; Arck, Petra C.

doi:10.1007/s00281-020-00807-y

Cited by 113 publications

(125 citation statements)

References 146 publications

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“…Feto-maternal tolerance is established in the first trimester, so any alteration during this period can lead to a deficient immunotolerance or immune maladaptation. This may involve inflammatory responses at the maternal-fetal interface that could be involved in adverse pregnancy outcomes [27]. Therefore, it is plausible that cytokines measured during the first trimester are a better predictor of PTB because key physiological processes occur or are initiated during this period.…”

Section: Discussionmentioning

confidence: 99%

Timing of Cervico-Vaginal Cytokine Collection during Pregnancy and Preterm Birth: A Comparative Analysis in the PRINCESA Cohort

Buxton

Meraz‐Cruz

Sánchez

et al. 2021

IJERPH

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Preterm birth (PTB), defined as birth before 37 completed weeks of gestation, is a major cause of infant morbidity and mortality. Inflammation is an important component in the physiopathologic pathway leading to PTB but results from cross-sectional studies on associations between inflammation, as measured by cytokines, and PTB are inconsistent. Timing of cytokine measurement during pregnancy varies between studies and may contribute to inconsistent findings. We investigated the effects of timing on associations between 16 cervico-vaginal cytokines (Eotaxin, IL-10, IL-12p40, IL-17, IL-1RA, sIL-2rα, IL-1a, IL-1β, IL-2, IL-6, IP-10, MCP-1, MIP-1α, MIP-1β, TNFα, and VEGF) and PTB among 90 women throughout pregnancy. We used logistic regression to compare associations between concentrations of cervico-vaginal cytokines from periods in pregnancy and PTB. Trimester 1 cytokines had the strongest positive associations with PTB; for example, OR = 1.76 (95% confidence interval: 1.28, 2.42) for IL-6. Second and third trimester associations were weaker but largely positive. IL-1α was the only cytokine with a negative association (trimesters 2, 3 and overall pregnancy). Strong first trimester associations between cytokines and PTB suggest that measuring cytokines early in pregnancy may hold promise for early identification of PTB risk. Variations in cytokine measurement during pregnancy may contribute to inconsistencies among studies.

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Section: Discussionmentioning

confidence: 99%

Timing of Cervico-Vaginal Cytokine Collection during Pregnancy and Preterm Birth: A Comparative Analysis in the PRINCESA Cohort

Buxton

Meraz‐Cruz

Sánchez

et al. 2021

IJERPH

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show abstract

“…41 An increase in circulating IL-1, IL-6 and TNF-α has been identified in both spontaneous term labour and preterm birth, and is thought to regulate prostaglandin release and activation via the cyclooxygenase-2 (COX-2) pathway. 42 The resulting cervical ripening, uterine contractions and placental detachment are all necessary components for normal birth. 42 The extent and timing of this cytokine cascade inevitably requires precise control, as excess inflammation (ie generated by autoimmune disease) may instigate early-onset delivery as epitomized in preterm labour.…”

Section: Infl Ammati On In Impl Antati On and Parturitionmentioning

confidence: 99%

“…42 The resulting cervical ripening, uterine contractions and placental detachment are all necessary components for normal birth. 42 The extent and timing of this cytokine cascade inevitably requires precise control, as excess inflammation (ie generated by autoimmune disease) may instigate early-onset delivery as epitomized in preterm labour. 33,43,44…”

Section: Infl Ammati On In Impl Antati On and Parturitionmentioning

confidence: 99%

Chronic histiocytic intervillositis: A breakdown in immune tolerance comparable to allograft rejection?

Brady

Williams

Sharps

et al. 2020

American J Rep Immunol

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From implantation of the embryo through to birth, successful pregnancy relies upon the promotion of a tolerogenic uterine environment to allow the foetus to thrive. 1 Simultaneously, and of equal importance, the maternal inflammatory response must be conserved to protect the mother and foetus against pathogens. 2 This "paradox" of pregnancy, first described by Sir Peter Medawar in the 1950s, 1 has prompted investigation into the immunology of pregnancy, particularly where it may be dysfunctional. Chronic histiocytic intervillositis (CHI), also known as chronic intervillositis (CI), chronic intervillositis of unknown aetiology

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“…When delivery is approaching, the in situ or recruited immune cells form an in ammatory reaction environment locally at the maternal-fetal interface, prompting the fetus to be delivered by the mother. Therefore, the maternal-fetal interface immune microenvironment regulates all aspects of pregnancy and childbirth, and disorder or abnormality in its balance can lead to miscarriage or PTB [17] . The accumulation of HBV-DNA in the placenta and trophoblast cells may trigger the placental in ammatory response at the maternal-fetal interface, prompting the fetus to be discharged from the mother.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Complicated With Hepatitis B Virus Infection and Preterm Birth: A Retrospective Cohort Study

Zheng¹,

Zhang²,

Chen³

et al. 2021

Preprint

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Background: We aimed to investigate whether maternal chronic hepatitis B virus (HBV) infection affects preterm birth（PTB) in pregnant women. Methods: We retrospectively analyzed HBV-infected and non-infected pregnant women attending antenatal care at Fujian Provincial Maternity and Child Health Hospital, Fuzhou, China between January 1, 2016 to December 31, 2018. Participants were divided into HBV infection (n = 1302) and control (n = 12813) groups. We compared baseline data, pregnancy and perinatal complications, and preterm delivery outcomes between groups and performed subgroup comparisons and multiple logistics regression analysis to adjust for confounding factors. Results: The incidence of PTBs before 37 weeks was similar between the groups. PTBs before 34 weeks were significantly more among the HBV infection group than among the controls (1.6% VS. 0.8% ; P = 0.003) After adjusting for confounding factors through logistics regression, HBV infection was found to be an independent PTB risk factor before 34 weeks gestation (adjusted odds ratio 1.796; 95% confidence interval[1.071, 3.012]). According to the subgroup analysis based on whether hepatitis B e-antigen (HBeAg) was positive and whether alanine aminotransferase (ALT) levels were normal during the second trimester, PTB was more frequent in HBeAg negative HBV infection before 34 weeks than among controls(1.8% VS. 0.8%). The PTB rate for pregnant women with normal ALT and HBV infection before 34 weeks was higher than that of the controls (1.6% VS. 0.8%) Conclusion HBV infection is an independent risk factor for PTB before 34 weeks. Comprehensive programs focusing on pregnant women with HBV infection would reduce the incidence of adverse outcomes.

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Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus

Cited by 113 publications

References 146 publications

Timing of Cervico-Vaginal Cytokine Collection during Pregnancy and Preterm Birth: A Comparative Analysis in the PRINCESA Cohort

Timing of Cervico-Vaginal Cytokine Collection during Pregnancy and Preterm Birth: A Comparative Analysis in the PRINCESA Cohort

Chronic histiocytic intervillositis: A breakdown in immune tolerance comparable to allograft rejection?

Pregnancy Complicated With Hepatitis B Virus Infection and Preterm Birth: A Retrospective Cohort Study

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