Abstract
Preterm birth is a leading cause of infant morbidity and mortality. Decorin and biglycan are proteoglycans that play key roles in maintaining the connective tissue matrix and tensile strength of human fetal membranes and have been previously linked to PPROM. Extracellular matrix proteins, such as matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), TIMP metallopeptidase inhibitor 1 (TIMP-1), TIMP metallopeptidase inhibitor 2 (TIMP-2), and collagen VI (COL-6), have also been linked to PPROM and may have utility in a serum-based screening model for this condition. To define the natural course of serum decorin and biglycan expression throughout the duration of healthy pregnancy, to explore patterns of serum decorin and biglycan expression in serum of asymptomatic women who go on to develop spontaneous preterm labor, and to investigate the potential role for matrix metalloproteinases, their inhibitors, and collagen VI in a serum-based screening model to predict PPROM. Serum decorin level decreases less than 1% per week, and serum biglycan decreases by 2.9% per week over the duration of healthy pregnancy. Serum decorin and biglycan concentrations do not differ in spontaneous preterm labor cases compared with those in controls. Mean concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2, and COL-6 do not differ in PPROM cases compared with those in controls. We have demonstrated that serum decorin and biglycan concentrations remain stable throughout the duration of normal pregnancy and are not early indicators of preterm labor, while common MMPs, TIMPs, and collagen VI are not early indicators of PPROM.
Highlights
Preterm birth, defined as births occurring before 37 completed weeks of gestation, is a leading cause of infant morbidity and mortality [1, 2]
Given that we previously demonstrated a significant difference in serum decorin and biglycan concentrations in asymptomatic women who went on to develop premature rupture of membranes (PPROM) compared with those in matched controls who delivered at term, as a step, we tested whether this pattern is similar in spontaneous preterm labor without rupture of membranes in order to ascertain whether the reported results were related to preterm birth in general or PPROM
We have demonstrated the natural course of serum decorin and biglycan expression throughout the duration of pregnancy
Summary
Preterm birth, defined as births occurring before 37 completed weeks of gestation, is a leading cause of infant morbidity and mortality [1, 2]. Brown University, Providence, RI, USA 4 Department of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI, USA affects approximately 11% of all livebirths worldwide [3] and is the most frequent cause of neonatal death [4]. It is associated with both short-term and long-term neonatal morbidity [5, 6]. PPROM is the spontaneous rupture of fetal membranes prior to labor before 37 weeks of gestation and accounts for about 30% of preterm births. The remainder of preterm births are due to maternal or fetal indications, in which labor is induced or the infant delivered by cesarean section prior to labor onset [7]
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