Abstract
To determine the role of caspase-3, apoptosis-inducing factor (AIF), and B-cell lymphoma-2 (Bcl-2) expressions in term premature rupture of membrane (PROM). An analytic observational study with case-control design was conducted, involving 52 subjects (37-42 weeks of gestation) who were divided into 2 groups: 26 cases of term delivery with PROM, and 26 controls of term delivery without PROM. The expressions of caspase-3, AIF, and Bcl-2 in the amniotic membrane were determined by immunohistochemistry. Data were analyzed using the chi-squared test. The risk of PROM was expressed by odds ratio (OR). There were no significant differences in age, parity and body mass index between the two groups (p > 0.05). High caspase-3 and AIF expressions increased the risk of PROM 17.64 times (OR = 17.64; 95% CI = 4.44-70.07; p = 0.001) and 9.45 times (OR = 9.45; 95% CI= 2.62-34.07; p = 0.001), respectively, while low Bcl-2 expression increased 10.39 times (OR = 10.39; 95% CI = 2.73-39.56; p = 0.001)the risk of PROM . High caspase-3 and AIF expressions and low Bcl-2 expression were risk factors for term PROM. Caspase-dependent and independent pathways of apoptosis were involved in the mechanism of PROM in term pregnancy.
Highlights
Premature rupture of the membrane (PROM) is one of the complications of pregnancy, and it is associated with maternal and neonatal morbidities.[1]
As we can see in ►Table 2, we have found that high expression of caspase-3 increases 17.64 times the risk of PROM, and that high apoptosis-inducing factor (AIF) expression increased 9.45 times the risk of PROM
We have found that low expression of Bcell lymphoma-2 (Bcl-2) increased 10.39 times the risk of PROM
Summary
Premature rupture of the membrane (PROM) is one of the complications of pregnancy, and it is associated with maternal and neonatal morbidities.[1] Term PROM is defined as the rupture of the fetal membrane prior to the onset of labor in a term pregnancy. The etiology of PROM is multi-factorial, and its pathobiological mechanisms are unclear.[2] One of the factors involved in the endogenous and exogenous mechanisms associated with the increased risk of PROM is the occurrence of programmed cell death, or apoptosis. The incidence of PROM worldwide varies between 5 and10%, and almost 80% of the cases occur at term pregnancy.[1,2] In China, the reported incidence of PROM is higher, around 19.53% of all pregnancies.[3] Budijaya et al (2017)[4] reported 212 cases of PROM in 1,450 deliveries (14.62%) at the Sanglah Hospital Denpasar, Bali, Indonesia; 179 cases (84.43%) were term received June 20, 2018 accepted September 18, 2018
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