Abstract
BACKGROUND: The oxytocin (OXT)-oxytocin receptor (OXTR) system provides promising candidate gene for studies of genetic contributions to prematurity. OBJECTIVE: Quantification and comparison of oxytocin receptor (OXTR) gene expression and serum OXT levels in the blood and amnion of women delivering preterm and evaluation of the correlation between OXTR gene expression in blood and amnion with serum OXT levels in them. METHODS: 70 pregnant women in spontaneous labor delivering vaginally preterm i.e < 37 weeks and equal number of matched controls delivering spontaneously at term (37-42 weeks) were recruited. Maternal serum OXT levels taken in active stage of labor (i.e 4 cm cervical dilatation) were quantified by ELISA. Gene expression studies in the maternal blood and amnion were done by using real time quantitative polymerase chain reaction (RT-qPCR). RESULTS: The mean serum OXT level in PTL was 48.56 +- 6.97 pg/ml; significantly higher than in controls (43.00 +- 3.96 pg/ml), p<0.001. OXTR gene expression both in maternal blood (2.5 times) and amnion (3.5 times) were significantly higher in PTL. A significant positive correlation was observed between serum OXT levels and OXTR gene expression in amnion (r = -0.190, p = 0.025). CONCLUSIONS: The serum OXT levels and OXTR gene expression in amnion surge significantly in active phase of PTL. Thus, amnion probably links OXT-PTGs autocrine paracrine circuit to facilitate PTL. Future studies are needed to devise better OXTR receptor antagonists preferably acting on amnionic OXTRs to prevent PTL. KEYWORDS: Preterm birth, Preterm labor, Oxytocin, Oxytocin receptor, Placenta, Amnion
Highlights
An estimated 15 million babies are born too early every year i.e., 1 in 10 babies
oxytocin receptor (OXTR) gene expression in amnion was significantly higher in preterm labor (PTL) (FC > 3.44) as compared to term labor (P < 0.001) (Fig. 2)
Increased mRNA levels encoding OXTR and other uterine activation proteins such as COX-2 or PTGF2α receptor in decidua after the onset of labor were observed in the uterine tissues during term and PTL [42], suggesting that the basic regulation for uterine activation was similar between term and PTL
Summary
An estimated 15 million babies are born too early every year i.e., 1 in 10 babies. 1 million children die each year due to complications of preterm birth (PTB) [1]. Prematurity is the leading cause of death in children under the age of 5 years [1]. PTB rates are increasing despite advancing knowledge of risk factors for preterm labor (PTL) and the introduction of public health and medical interventions [2,3,4,5,6]. Key treatments for PTL have focused on the prevention or inhibition of myometrial contractions, mainly to provide time to administer steroids to aid fetal lung maturation and transfer to a special neonatal care unit [7, 8]
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