The influence of systemic inflammatory markers on the development of obstetrical complications in pregnant women with chronic obstructive pulmonary disease
DOI:
https://doi.org/10.14739/2310-1210.2023.1.264437Keywords:
pregnancy, chronic obstructive pulmonary disease, labor complications, bronchial obstruction, cytokinesAbstract
The increasing prevalence of chronic obstructive pulmonary disease (COPD) among the female half of the population is the reason for the increased interest of scientists in the course of COPD and its impact on pregnant women. At the same time, the chronic lung inflammatory process leads to the development of obstetrical and perinatal complications during pregnancy.
The aim of our study is to establish the features of changes in the cytokine profile in pregnant women with COPD and their role in the development of obstetrical and perinatal complications.
Materials and methods. 77 pregnant women with clinically and instrumentally verified signs of COPD were examined, who were divided into 2 subgroups depending on the degree of bronchial obstruction: IA – 43 pregnant women with FEV1 ≥80 %, IB – 34 pregnant women with FEV1 50–79 %. The control group consisted of 27 healthy pregnant women. The cytokine profile was determined and a correlational interaction with the degree of bronchial obstruction and the frequency of obstetrical and perinatal complications was established.
Results. Our analysis of cytokine profile indicators in pregnant women with COPD at the stage of mild and moderate bronchoobstruction has shown a characteristic and significant increase in the level of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and a simultaneous decrease in the level of anti-inflammatory IL-10 (P ≤ 0.05). Dysregulation of the inflammatory response in COPD in pregnant women became the main basis for the development of obstetrical and perinatal complications. We have established that an increase in the degree of bronchoobstruction was also associated with a higher detection frequency of such pregnancy and childbirth complications as anemia by 3.1 times, the threat of preterm birth by 9 times, preeclampsia by 7 times, placental dysfunction by 3.4 times, intrauterine growth restriction by 8 times, premature birth by 3.5 times, premature rupture of membranes during labor by 4 times, and fetal distress by 3 times.
Conclusions. In pregnant women with COPD, an increase in the level of pro-inflammatory cytokines – IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0.78), IL-8, TNF-α was found to be directly proportional to the degree of bronchial obstruction, and inversely proportional level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which can be an early prognostic criterion for the development of obstetrical and perinatal complications.
References
Jenkins, C. (2021). Differences between men and women with chronic obstructive pulmonary disease. Clinics in chest medicine, 42(3), 443-456. https://doi.org/10.1016/j.ccm.2021.06.001
GBD 2015 Chronic Respiratory Disease Collaborators. (2017). Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. Respiratory Medicine, 5(9), 691. https://doi.org/10.1016/S2213-2600(17)30293-X
Tamási, L., Horváth, I., Bohács, A., Müller, V., Losonczy, G., & Schatz, M. (2011). Asthma in pregnancy–immunological changes and clinical management. Respiratory medicine, 105(2), 159-164. https://doi.org/10.1016/j.rmed.2010.11.006
Orru, H., Ebi, K. L., & Forsberg, B. (2017). The interplay of climate change and air pollution on health. Current environmental health reports, 4(4), 504-513. https://doi.org/10.1007/s40572-017-0168-6
Rodriguez, M. E. S., & Silveyra, P. (2022). Editor’s Pick: Air Pollution Exposure as a Relevant Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbations in Male and Female Patients. EMJ. https://doi.org/10.33590/emj/21-00228
Ali, S., Majid, S., Ali, M. N., Taing, S., Rehman, M. U., & Arafah, A. (2021). Cytokine imbalance at materno-embryonic interface as a potential immune mechanism for recurrent pregnancy loss. International Immunopharmacology, 90, 107118. https://doi.org/10.1016/j.intimp.2020.107118
Obling, N., Backer, V., Hurst, J. R., & Bodtger, U. (2022). Nasal and systemic inflammation in Chronic Obstructive Pulmonary Disease (COPD). Respiratory Medicine, 195, 106774. https://doi.org/10.1016/j.rmed.2022.106774
Mor, G., & Kwon, J. Y. (2015). Trophoblast-microbiome interaction: a new paradigm on immune regulation. American journal of obstetrics and gynecology, 213(4), S131-S137. https://doi.org/10.1016/j.ajog.2015.06.039
Silva, B. S. A., Lira, F. S., Ramos, D., Uzeloto, J. S., Rossi, F. E., Freire, A. P. C. F., Silva, R. N., Trevisan, I. B., Gobbo, L. A., & Ramos, E. M. C. (2018). Severity of COPD and its relationship with IL-10. Cytokine, 106, 95-100. https://doi.org/10.1016/j.cyto.2017.10.018
Huang, A. X., Lu, L. W., Liu, W. J., & Huang, M. (2016). Plasma Inflammatory Cytokine IL-4, IL-8, IL-10, and TNF-α Levels Correlate with Pulmonary Function in Patients with Asthma-Chronic Obstructive Pulmonary Disease (COPD) Overlap Syndrome. Medical science monitor, 22, 2800-2808. https://doi.org/10.12659/msm.896458
Macnab, W. R. (2022). Functions of the placenta. Anaesthesia and Intensive Care Medicine, 23(6). 344-346. https://doi.org/10.1016/j.mpaic.2022.03.003
Žák, P., & Souček, M. (2019). Correlation of tumor necrosis factor alpha, interleukin 6 and interleukin 10 with blood pressure, risk of preeclampsia and low birth weight in gestational diabetes. Physiological research, 68(3), 395-408. https://doi.org/10.33549/physiolres.934002
Azizieh, F. Y., & Raghupathy, R. (2017). IL-10 and pregnancy complications. Clinical and Experimental Obstetrics & Gynecology, 44(2), 252-258. https://doi.org/10.12891/ceog3456.2017
Gupta, N., Malhotra, N., & Ish, P. (2021). GOLD 2021 guidelines for COPD - what's new and why. Advances in respiratory medicine, 89(3), 344-346. https://doi.org/10.5603/ARM.a2021.0015
Reddel, H. K., Bacharier, L. B., Bateman, E. D., Brightling, C. E., Brusselle, G. G., Buhl, R., Cruz, A. A., Duijts, L., Drazen, J. M., FitzGerald, J. M., Fleming, L. J., Inoue, H., Ko, F. W., Krishnan, J. A., Levy, M. L., Lin, J., Mortimer, K., Pitrez, P. M., Sheikh, A., Yorgancioglu, A. A., … Boulet, L. P. (2022). Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes. The journal of allergy and clinical immunology. In practice, 10(1S), S1-S18. https://doi.org/10.1016/j.jaip.2021.10.001
Ministry of Health of Ukraine. (2013, October 8). Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry bronkhialnii astmi. Nakaz MOZ Ukrainy vid 08.10.2013 No. 868 [On the approval and implementation of medical and technological documents on the standardization of medical care for bronchial asthma (No. 868)]. https://zakon.rada.gov.ua/rada/show/v0868282-13#Text
Ministry of Health of Ukraine. (2013, June 27). Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry khronichnomu obstruktyvnomu zakhvoriuvanni lehen. Nakaz MOZ Ukrainy vid 27.06.2013 No. 555 [On the approval and implementation of medical and technological documents on the standardization of medical care for chronic obstructive pulmonary disease (No. 555)]. https://zakon.rada.gov.ua/rada/show/v0555282-13
Zaikov, S. V., Grishylo, A. P., & Grishylo, P. V. (2014). Bronkhoobstruktyvnyi syndrom i mozhlyvosti yoho efektyvnoi korektsii [Bronchial obstruction syndrome and options for its effective correction]. Ukrainskyi pulmonolohichnyi zhurnal, (4), 25-30. [in Ukrainian].
Khong, T. Y. (2015). Pathology of early pregnancy loss. In T. Y. Khong, & R. D. G. Malcomson (Eds.), Keeling’s Fetal and Neonatal Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-19207-9_2
Skrypchenko, N., Mazur, T., Vorobyova, I., & Tkachenko, V. (2019). Otsinyuvannya tsytokinovoho statusu zhinok z nevynoshuvannyam khvoroby [Evaluation of the cytokin status of women with miscarriage]. Zdorove zhenshchiny, (4), 59-63. [in Ukrainian].
Chen, Y. H., Keller, J., Wang, I. T., Lin, C. C., & Lin, H. C. (2012). Pneumonia and pregnancy outcomes: a nationwide population-based study. American journal of obstetrics and gynecology, 207(4), 288-e1. https://doi.org/10.1016/j.ajog.2012.08.023
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