Umbilical cord prostaglandins in term and preterm parturition

Hong, J. S. and Romero, R. and Lee, D. C. and Than, Nándor Gábor and Yeo, L. (2016) Umbilical cord prostaglandins in term and preterm parturition. JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 29 (4). pp. 523-531. ISSN 1476-7058

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Abstract

OBJECTIVE: Prostaglandins (PGs) are considered the universal mediators of parturition. Amniotic fluid PGE2 and PGF2alpha 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 PGE2 and PGF2alpha 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. PGE2 and PGF2alpha were measured by specific immunoassays. Non-parametric statistics were used for analysis. RESULTS: (1) In spontaneous preterm deliveries, the median UC PGE2 concentration was higher in cases with funisitis than in those without funisitis (233.7 pg/microg versus 87.4 pg/microg of total protein, p = 0.001); (2) the median UC PGE2 concentration in sPTD with funisitis was also higher than that obtained from samples who had undergone labor at term (233.7 pg/microg versus 116.1 pg/microg of total protein, p = 0.03); (3) the UC PGE2 and PGF2alpha concentration increased as a function of advancing gestational age before 36 weeks (PGE2: rho = 0.59, p < 0.001; PGF2alpha: rho = 0.39, p = 0.01), but not after 36 weeks (PGE2: rho = -0.1, p = 0.5; PGF2alpha: rho = -0.2, p = 0.2); (4) the median UC concentrations of PGE2 and PGF2alpha at term was similar in samples obtained from women with and without labor (PGE2: TNL 133.7 pg/microg versus TIL 116.1 pg/microg of total protein, p = 0.9; PGF2alpha: TNL 8.4 pg/microg versus TIL 8.1 pg/microg of total protein, p = 0.7); and (5) there was no correlation between UC PG concentration and gestational age at term pregnancy (PGE2: rho = 0.01, p = 0.9; PGF2alpha: rho = 0.07, p = 0.7). CONCLUSIONS: (1) PGE2 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 PGE2 and PGF2alpha; and (3) the UC concentrations of PGE2 and PGF2alpha increased as a function of gestational age. We propose that UC PGs act as inflammatory mediators generated in the context of fetal systemic inflammation.

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