Abstract
A prelabor rupture of membranes (PROM) and its subtypes, preterm PROM (pPROM) and term PROM (tPROM), are associated with disturbances in the hemostatic system and angiogenesis. This study was designed to demonstrate the role of single nucleotide polymorphisms (SNPs), localized in CSF2 (rs25881), FLT1 (rs722503), TFPI (C-399T) and TLR9 (rs352140) genes, in PROM. A population of 360 women with singleton pregnancy consisted of 180 PROM cases and 180 healthy controls. A single-SNP analysis showed a similar distribution of genotypes in the studied polymorphisms between the PROM or the pPROM women and the healthy controls. Double-SNP TT variants for CSF2 and FLT1 polymorphisms, CC variants for TLR9 and TFPI SNPs, TTC for CSF2, FLT1 and TLR9 polymorphisms, TTT for FLT1, TLR9 and TFPI SNPs and CCCC and TTTC complex variants for all tested SNPs correlated with an increased risk of PROM after adjusting for APTT, PLT parameters and/or pregnancy disorders. The TCT variants for the CSF2, FLT1 and TLR9 SNPs and the CCTC for the CSF2, FLT1, TLR9 and TFPI polymorphisms correlated with a reduced risk of PROM when corrected by PLT and APTT, respectively. We concluded that the polymorphisms of genes, involved in hemostasis and angiogenesis, contributed to PROM.
Highlights
Based on the gestational age at the time of membrane rupture, the prelabor rupture of membranes (PROM) is divided into a preterm PROM, if the disturbance occurs before the 37th week, and the term PROM, observed from the
We found that the CC double-single nucleotide polymorphisms (SNPs) variants for the TLR9 rs352140 and tissue factor pathway inhibitor (TFPI) C-399T SNPs were associated with an approximately two-fold higher risk of PROM when the results were corrected by activated partial thromboplastin time (APTT)
Taking into account triple-SNP variants for CSF2, FLT1 and TLR9 polymorphisms, we found that TTC variants correlated with an approximately 20-fold increased risk of PROM when adjusted by APTT, while TCT variants were associated with a decreased risk of the disease after correction by the PLT count
Summary
Based on the gestational age at the time of membrane rupture, the PROM is divided into a preterm PROM (pPROM), if the disturbance occurs before the 37th week, and the term PROM (tPROM), observed from the. TPROM is diagnosed in roughly 8% of full-term pregnancies, followed by adverse maternal and perinatal outcomes, including placental abruption, cord compression, cord prolapse, a risk of caesarean delivery and maternal and neonatal infection [1,2,4]. PPROM is associated with an increased risk of intra-amniotic infection, acute and chronic histological chorioamnionitis, clinical chorioamnionitis, cord prolapse, placental abruption and postpartum endometritis [8,9,10,11]. The complications in neonates include pulmonary hypoplasia, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), adverse neurodevelopmental outcomes, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), cardiovascular diseases, necrotizing enterocolitis (NEC), sepsis and death [9,10]
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