Assessment of Biomarkers of Intrauterine Inflammation Induced Preterm Labor

Abstract

Preterm labor, classified as birth before 37 weeks, is the manifestation of uterine contractions with sufficient frequency and intensity to cause progressive cervical thinning and dilation of the cervix prior to term gestation. Preterm labor is a consequence of a complex cluster of complications with many overlapping factors. Amongst this cluster of problems, intrauterine infection and inflammation pathway is widely studied as a source of preterm labor (Johnson et al., 2014; Viscardi et al., 2004; Tency, 2014). Intrauterine infection can be described as the presence of microorganisms in the amniotic cavity. The chemical mediators that are released as a result of an immune response to infection include cytokines and chemokines, prostaglandins and matrix-degrading enzymes. These chemical mediators are proposed as possible biomarkers of intrauterine infection (Challis et al., 2002). Biomarkers are objective indicators of a certain medical state that can be measured using various laboratory procedures. The identification of biomarkers for intrauterine infection can help predict clinical outcome as well as direct treatment methods to preempt potential preterm labor (Strimbu and Tavel, 2011). Numerous research studies including Kusanovic (2010), Tency (2014), Amalinei (2007), Romero (1990), and Bernal (1987), have found increases in sTREM-1, MMP, cytokine, and prostaglandin concentrations during intrauterine infection. Currently there are various antibiotic regimens that have been shown to have significant effect in preventing the progression of bacterial vaginosis, in pregnant women. Bacterial vaginosis is the existence of infectious bacteria in the vagina. Normally, this mild infection in the vagina will disappear; however, in if it does not, bacterial vaginosis will progress to the advanced state of intrauterine infection, termed chorioamnionitis. Thus, these antibiotic regimens are not effective in treating the pathological state, of intrauterine infection and chroioamnioitis (Ovalle et al., 2006; Hutzal et al., 2008). However, recent findings regarding the heterologous etiology of preterm labor have promise for the development of an effective treatment. Using reliable biomarkers in conjunction with targeted therapy towards known contributors to preterm labor may result in a decrease in the occurrence of preterm labor and increase the health of newborns.