DOI: https://doi.org/10.22263/2312-4156.2016.4.46
Dziadzichkina V.V., Radetskaya L.E.
The use of innate immunity parameters for the assessment of spontaneous premature birth risk
Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Vitebsk, Republic of Belarus
Vestnik VGMU. 2016;15(4):46-54.
Abstract.
Objectives. To determine the diagnostic value of the indices of intracellular and extracellular neutrophilic granulocytes activity, regulators of cellular immunity (highly sensitive C-reactive protein, interleukin 8, chemokine CXCL10) in female patients with threatening interruption of pregnancy for the assessment of spontaneous premature birth risk .
Material and methods. The study involved 122 female patients with single pregnancy at the term of 22-34 weeks of gestation who were hospitalized with a diagnosis of threatening premature labor. Reactive oxygen species production and absorption capacity of neutrophils, their ability to form neutrophic extracellular traps in the peripheral blood, the concentration of highly sensitive C-reactive protein, interleukin 8 and chemokine CXCL10 in blood serum, vaginal pH, cervical length were identified in all women. Logistic regression analysis was used to assess the risk of spontaneous premature birth based on the studied parameters.
Results. A method to assess the risk of spontaneous premature delivery, which includes the determination of the cervix length at the term of 18-21 weeks of gestation according to echoscopy, vaginal pH, concentration of highly sensitive C-reactive protein, respiratory reserve index of peripheral blood neutrophils has been elaborated. This method allows to prognosticate spontaneous premature birth with the sensitivity of 82,6%, specificity of 89,9% and diagnostic efficiency of 88,0%. The positive predictive value made up 73,1% and negative predictive value was 93,9%.
Conclusions. The developed method of the assessment of spontaneous premature birth risk can be used to create individual patterns for the adequate treatment of patients with threatening interruption of pregnancy.
Key words: spontaneous premature delivery, risk prediction, neutrophilic granulocytes.
References
1. World Health Organization. Born Too Soon: The Global Action Report on Preterm Birth. Geneva; 2012. 126 p.
2. Skripnichenko YuP, Baranov II, Tokova ZZ. Statistika prezhdevremennykh rodov [Statistics of premature births]. Problemy Reproduktsii. 2014;(4):11-4.
3. Nats Stat Komitet Resp Belarus'. Zdorov'e naseleniia Respubliki Belarus' [Health of the population of Republic of Belarus]: ctat sb. Minsk, RB; 2014. 218 р.
4. Aylamazyan EK, Evsyukova II. Diskussionnye problemy prezhdevremennykh rodov i vykhazhivaniia detei s ekstremal'no nizkoi massoi tela [Debatable problems of premature births and nursing of children with extremely low body weight]. Zhurn Akusherstva Zhen Boleznei. 2011;60(3):183-9.
5. Aleksandrovich YuS, Gordeev VI, Pshenisnov KV. Intensivnaia terapiia infektsionnykh zabolevanii u detei [An intensive care of infectious diseases at children]. Saint-Petersburg, RF: Elbi-SPb; 2010. 320 р.
6. Serova OF, Tamazyan GV, Malyutina LV, Petrova AS, Beketovskiy VYu, Bardacheva AV i dr. Taktika vedeniia nedonoshennykh novorozhdennykh s ekstremal'no nizkoi i ochen' nizkoi massoi tela ot zhenshchin s prezhdevremennym razryvom plodnykh obolochek [Tactics of maintaining prematurely born newborns with extremely low and very low body weight from women with a premature rupture of fetal covers]. Effektiv Farmakoterapiia. 2014;(38);10-3.
7. Radzinskiy VE, Galina TV, Kostin IN, Gagaev ChG. Predlozheniia po aktualizatsii deistvuiushchego obshcherossiiskogo protokola po profilaktike, diagnostike i vedeniiu prezhdevremennykh rodov [Offers on updating of the existing all-Russian protocol on prophylaxis, diagnostics and conducting premature birth]. Status Praesens. 2014;(6):119-22.
8. Iams JD, Newman RB, Thom EA, Goldenberg RL, Mueller-Heubach E, Moawad A et al. Frequency of uterine contractions and the risk of spontaneous preterm delivery. N Engl J Med. 2002 Jan;346(4):250-5.
9. Behrman RE, Butler AS. Preterm birth: causes, consequences and prevention. Washington: National academies press; 2007. 310 p.
10. Barber MA, Eguiluz I, Plasencia W, Medina M, Valle L, Garcia JA. Preterm delivery and ultrasound measurement of cervical length in Gran Canaria, Spain. Int J Gynaecol Obstet. 2010 Jan;108(1):58-60.
11. Tsirkin VI, Anisimov KYu, Polezhaeva TV, Zaytseva OO, Khudyakov AN, Solomina ON i dr. Rol' neitrofilov pri fiziologicheskom techenii beremennosti, rodov i riade akusherskikh oslozhnenii [A role of neutrophils at the physiological course of pregnancy, labors and a series of obstetric complications]. Vestn Ural Med Akadem Nauki. 2015;(4):75-86.
12. Novikov DK, Novikova VI. Otsenka immunnogo statusa [Assessment of the immune status]. Moscow, RF; Vitebsk, RB; 1996. 282 р.
13. Dyadichkina OV, Korotin OL, Radetskaya LE, Generalov II. Vozmozhnosti liuminestsentnoi i svetovoi mikroskopii pri opredelenii vnekletochnykh neitrofil'nykh lovushek [Possibilities of a luminescent and light microscopy when determining extracellular neutrophylic traps]. Vestn VGMU. 2014;13(5):81-6.
14. Trukhacheva NV. Matematicheskaia statistika v mediko-biologicheskikh issledovaniiakh s primeneniem paketa Statistica [Mathematical statistics in medicobiological researches with use of a Statistica package]. Moscow, RF: GEOTAR-Media; 2013. 379 р.
15. Dyadichkina OV, Radetskaya LE. Vliianie progesterona na okislitel'nuiu aktivnost' neitrofilov vo vremia beremennosti [Influence of Progesteronum on oxidizing activity of neutrophils during pregnancy]. V: Perinatal'naia meditsina: ot pregravidal'noi podgotovki k zdorovomu materinstvu i detstvu: tez II Obshcheros konf s mezhdunar uchastiem, Sankt-Peterburg, 18-20 fevr 2016 g. Moscow, RF: Status Presens; 2016. Р. 16-7.
Information about authors:
Dziadzichkina V.V. – postgraduate of the Chair of Obstetrics & Gynecology, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University»;
Radeckaya L.E – Doctor of Medical Sciences, professor of the Chair of Obstetrics & Gynecology, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University».
Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Chair of Obstetrics & Gynecology. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Dziadzichkina Volha V.
