The role of immune factors in the development of preterm birth

Preterm birth (PB) carries a high risk of developing neuropsychological development disorders, cognitive and somatic problems in the child. The maternal immune system plays a critical role in maintaining a physiological pregnancy. However, specific mechanisms and disorders of pregnancy development have been little studied. There is a lack of research on the role of immune competent cell (ICC) activation in preterm labor leading to uterine contractility. Understanding the importance of immune system factors in the formation of preterm birth may allow the development of strategies to prolong pregnancy and, thus, lead to improved perinatal outcomes. The purpose of the work is to study the role of immune factors in the development of preterm birth. Seventy pregnant women in the third trimester with recurrent miscarriage (RPL) and 25 healthy pregnant women (control group) were examined. Observed pregnant women with RPL were divided into two groups: Group I – patients who gave birth prematurely (n = 30); and Group II – patients who gave birth at term (n = 40). The population and subpopulation composition of peripheral blood lymphocytes was studied by cytofluorimetry using monoclonal antibodies to: CD3, CD4, CD8, CD16, CD19 (JSC "Sorbent", Russia) (FITC), CD11b (Beckman Coulter, USA); CD14, CD25, CD69, CD71, CD28, CD107a, HLA-DR (Beckman Coulter, USA) (PE). To create a database and conduct statistical research, the capabilities of an Excel spreadsheet and application packages (Megastat and Statistica 6.0) were used. When determining statistical significance between the study groups, the Mann-Whitney test was used for independent groups and the Wilcoxon test for dependent groups.

Modulation of the number and functional activity of ICC in patients with RPL had a significant correlation with pregnancy outcome. Inadequate activation of the immune system is a factor that can lead to miscarriage. Termination of pregnancy before term is associated with subpopulation shifts, increased activation potencies of immunocompetent cells compared to full-term birth, which is an important feature of the inflammatory response. The identified immune changes will allow the development of early prevention methods and new approaches to the treatment of this pregnancy complication.