Effect of Maternal Variables on some Physiological and Immunological Biomarkers in Iraqi Women Undergoing Caesarean Section
Main Article Content
Keywords
Maternal variables, Caesarean section, Abortion, Maternal age, Placenta.
Abstract
Pregnancy and childbirth are physiological states characterized by sudden hormonal and immunologically described changes. The current study aimed to investigate the influence of maternal variables (age, previous abortion, placental position, and fetal position) on some physiological biomarkers, such as oxytocin (OT), prolactin (PRL), cortisol, and insulin growth factor 2 (IGF -2) and some immune biomarkers such as programmed cell death protein 1 (PD-1), programmed cell death ligand 1 (PD-L1) and interleukin 6 (IL-6) in Iraqi women undergoing caesarean section (CS). Blood samples were collected from 48 pregnant women in the age range (16-43 years) and serum was obtained to determine the levels of the above biomarkers.
The effect of maternal age on physiological biomarkers showed that OT levels increased significantly with maternal age (P≤0.001), whereas PRL, cortisol, and IGF-2 levels were not (P˃0.05), showing differences between age categories. The effect of maternal age on immune biomarkers showed that PD-1 levels decreased significantly (P<0.05) and PD-L1 and PD-1/PD-L1 levels were highly significant (P≤ 0.001), however, IL-6 level shows a non-significant (P˃0.05) difference between age categories. Regarding the effect of previous abortion, statistical analysis showed that cortisol levels were significantly (P<0.05) lower in women with previous abortion compared to women without previous abortion, while OT, PRL, and IGF-2 levels were not significantly different (P ˃ 0.05) difference between the two groups. PD-1 and PD-L1 levels showed a significant (P<0.05) decrease in women with previous abortion compared with women without abortion, while IL-6 mirror images did not differ significantly (P˃0.05) between the two groups. The effect of placenta position showed that when the placenta was in the anterior position, the PRL level was significantly increased (P≤0.001), IGF-2 level was significantly decreased (P<0.05), while the OT and cortisol levels were significantly higher (P≤0.001) compared with the posterior position There was no significant difference between the two groups (P˃0.05). When the placenta was located in the anterior compared with the posterior, the level of PD-L1 was significantly (P<0.05) lower, while the levels of PD-1 and PD -1/PD- were not significantly different (P˃0.05). L1 and IL-6 between the two groups. According to fetal position, statistical analysis showed no significant difference in all physiological and immune biomarkers when the fetus was in cephalic or breech position (P˃0.05).
It can be concluded that the more maternal variables which affect on the physiological and immunological biomarkers of the women undergoing caesarean section are maternal age and a previous abortion.
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22. Kahveci B, Melekoglu R, Evruke IC, Cetin C. The effect of advanced maternal age on perinatal outcomes in nulliparous singleton pregnancies. BMC Pregnancy and Childbirth. 2018; 18(1): 1-7.
23. Torner L, Toschi N, Nava G, Clapp C, Neumann ID. Increased hypothalamic expression of prolactin in lactation: involvement in behavioural and neuroendocrine stress responses. European Journal of Neuroscience. 2002; 15(8): 1381-1389.
24. Nephew B, Murgatroyd C. The role of maternal care in shaping CNS function. Neuropeptides. 2013; 47(6): 371-378.
25. Handlin L, Jonas W, Petersson M, Ejdebäck M, Ransjö-Arvidson A, Nissen E, Uvnäs-Moberg K. Effects of sucking and skin-to-skin contact on
maternal ACTH and cortisol levels during the second day postpartum-influence of epidural analgesia and oxytocin in the perinatal period. Breastfeeding Medicine. 2009:, 4(4): 207-220.
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27. Paczkowski M, Schoolcraft WB, Krisher RL. Dysregulation of methylation and expression of imprinted genes in oocytes and reproductive tissues in mice of advanced maternal age. Journal of Assisted Reproduction and Genetics. 2015; 32(5): 713-723.
28. Bergman D, Halje M, Nordin M, Engström W. Insulin-like growth factor 2 in development and disease: a mini-review. Gerontology. 2013; 59(3): 240-249.
29. Pinheiro RL, Areia AL, Mota Pinto A, Donato H. Advanced maternal age: adverse outcomes of pregnancy, a meta-analysis. Acta Medica Portuguesa. 2019; 32(3): 219-226.
30. Okuyama M, Mezawa H, Kawai T, Urashima M. Elevated soluble PD-L1 in pregnant women’s serum suppresses the immune reaction. Frontiers in Immunology. 2019; 10(86): 1-8.
31. Levenson, D., Romero, R., Garcia-Flores, V., Miller, D., Xu, Y., Sahi, A., Hassan, S. S. and Gomez-Lopez, N. 2020. The effects of advanced maternal age on T-cell subsets at the maternal–fetal interface prior to term labor and in the offspring: a mouse study. Clinical and Experimental Immunology, 201(1), 58–75.
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33. Zhang Y, Ma L, Hu X, Ji J, Mor G, Liao A. The role of the PD-1/PD-L1 axis in macrophage differentiation and function during pregnancy. Human Reproduction. 2019; 34(1): 25-36.
34. Pieczyńska J, Płaczkowska S, Pawlik-Sobecka L, Kokot I, Sozański R, Grajeta H. Association of dietary inflammatory index with serum IL-6, IL-10, and CRP concentration during pregnancy. Nutrients. 2020; 12(9): 2789.
35. Christian LM, FrancoA, Glaser R, Iams JD. Depressive symptoms are associated with elevated serum proinflammatory cytokines among pregnant women. Brain, Behavior and Immunity. 2009; 23(6): 750-754.
36. Hadley EE, Richardson LS, Torloni MR , Menon R. Gestational tissue inflammatory biomarkers at term labor: A systematic review of literature. American Journal of Reproductive Immunology. 2018; 79(2): 1-11.
37. Jobst A, Krause D, Maiwald C, Härtl K, Myint AM, Kästner R, Obermeier M, Padberg F, Brücklmeier B, Weidinger E. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms. Archives of Women’s Mental Health. 2016; 19(4): 571-579.
38. Zanardo V, Volpe F, Parotto M, Giiberti L, Selmin A, Straface G. Nitrous oxide labor analgesia and pain relief memory in breastfeeding women. The Journal of Maternal-Fetal and Neonatal Medicine. 2018; 31(24):3243-3248.
39. Green E S, Arck P C. Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus. Seminars in Immunopathology. 2020; 42(4): 413-429.
40. Zhu P, Wang W, Zuo R, Sun K. Mechanisms for establishment of the placental glucocorticoid barrier, a guard for life. Cellular and Molecular Life Sciences. 2019; 76(1): 13-26.
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Jun 4, 2023
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Huda Sajir Naser, Makarim Qassim Al-Lami, & Haider Faisal Ghazi. (2023). Effect of Maternal Variables on some Physiological and Immunological Biomarkers in Iraqi Women Undergoing Caesarean Section. Journal of Population Therapeutics and Clinical Pharmacology, 30(13), 252–264. https://doi.org/10.47750/jptcp.2023.30.13.025
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