Urocortin in Second Trimester Amniotic Fluid: Its Role as Predictor of Preterm Labor

C Iavazzo,D Hassiakos,D Gourgiotis,M Boutsikou,K Tassis,L Florentin-Arar,C Vogiatzi,A Malamitsi-Puchner,S Baka

doi:10.1155/2009/947981

Abstract

Backgound. The existence of a “placental clock” which determines the duration of gestation has been previously proposed. It is related to placental CRH secretion and is active from an early phase in human pregnancy. Urocortin is a specific ligand for the corticotropin-releasing factor (CRF) receptor expressed by human trophoblast and fetal membranes. The purpose of this study was to evaluate whether urocortin concentrations in the early second trimester amniotic fluid might serve to predict preterm delivery. Method. The urocortin concentrations in early second trimester amniotic fluid were measured in 41 pregnancies with term delivery and in 41 pregnancies with preterm delivery by using an immunoradiometric assay. Conditional logistic regression analysis was used for statistical analysis. Results. Mean amniotic fluid urocortin concentrations in women with preterm labor were 1.55 ± 0.63 ng/mL while those in women with term labor were 1.6 ± 0.49 ng/mL (p: NS). No statistical significant results were found when comparing amniotic fluid urocortin concentrations in women with preterm premature rupture of membranes leading to preterm labor (n = 19) to women with term delivery without premature rupture of membranes. Conclusion. These results suggest that urocortin concentrations in the amniotic fluid of genetic amniocentesis are not predictive of preterm labor and birth.

Highlights

Preterm labor affecting 10%–15% of all pregnancies [1] is responsible for increased perinatal mortality and morbidity, for cerebral palsy [2]
Out of 362 pregnant women who were included in the study, 41 had preterm labor and a subgroup of 19 women delivered preterm with premature rupture of membranes
The amniotic fluid levels of urocortin in women with premature rupture of membranes were not higher than in women at term (1.64 ± 0.54 ng/mL versus 1.6 ± 0.49 ng/mL (Figure 1(b)). This is the first study which examined an association between amniotic fluid urocortin levels and possible prediction of preterm labor among asymptomatic women during the second trimester of pregnancy

Summary

Introduction

Preterm labor affecting 10%–15% of all pregnancies [1] is responsible for increased perinatal mortality and morbidity, for cerebral palsy [2]. Anatomic, or medical risk factors are associated with preterm labor, 50% of such cases are idiopathic. An inflammatory process was proposed by many authors. Increased amniotic fluid levels of cytokines as IL-6, TNFα, IL1-ra, IL-8, ADAM-8, and ITAC [3,4,5] were determined and were considered to serve as predictors of preterm labor. Other investigators suggest the “placental clock” model in the prediction of labor onset [6]. It was proposed that fetal or maternal stress might play a significant role in initiating the cascade of intracellular signals leading to preterm labour [7]

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Conclusion