Multi-Approach Analysis of MMP-9 in PROM and PPROM: Histopathological and Network-Based Perspectives

Objective: This study investigates the role of matrix metalloproteinase-9 (MMP-9) in prelabor rupture of membranes (PROM) and preterm PROM (PPROM) by integrating histological analysis with bioinformatics-based molecular network assessment. Methods: Placental tissue samples were collected from 25 control, 25 PROM, and 25 PPROM cases. MMP-9 expression was analyzed via immunohistochemistry, and histological changes were examined. Modular network analysis of MMP-9 was performed using Cytoscape and STRING databases, with clustering conducted using the MCODE plugin and functional enrichment assessed via Enrichr platform. P-values less than 0.05 were considered statistically significant. Results: Immunohistochemical analysis revealed a progressive increase in MMP-9 expression from control to PROM and PPROM placentas, with the highest expression observed in PPROM cases. Structural disruptions, including fibrin deposition and connective tissue irregularities, were more pronounced in PPROM (p