Placenta-associated complications as risk factors for induction of preterm labor: perinatal aspects

Objective. To determine risk factors for induction of preterm labor and the severity of oxidative stress in fetuses undergoing abdominal delivery due to placenta-associated complications. Material and methods. A total of 152 pregnant women were examined and divided into two groups. The study group included 102 patients with abdominal preterm labor induced by placenta-associated complications. The comparison group consisted of 50 pregnant women who had a planned term cesarean section for obstetric indications with satisfactory fetal condition. The practical significance of malondialdehyde, matrix metalloproteinases of the 1st and 9th families, and their tissue inhibitor (TIMP-1) was studied as predictors of cerebral disorders in preterm fetuses/newborns during induction of preterm labor due to life-threatening conditions for the mother and fetus. Results. The following clinical and anamnestic risk factors were established for induction of preterm labor in pregnant women with developed placenta-associated complications: hypertensive disorders (odds ratio, OR, 13.9); chronic pelvic inflammatory diseases; genital infections (OR, 4.06); urinary tract infections (OR, 3.3); and a history of two or more artificial abortions (OR, 3.2). Malondialdehyde, matrix metalloproteinases of families 1 and 9, and their tissue inhibitor, TIMP-1, were identified in biological fluids as laboratory predictors of the severity of cerebral disorders in premature fetuses/newborns. Conclusion. Predicting the severity of cerebral disorders in fetuses during preterm abdominal delivery by determining the concentration of malondialdehyde in amniotic fluid, the activity of matrix metalloproteinases of families 1 and 9, and their tissue inhibitor, as well as their early detection in cord blood, allows for the initiation of rehabilitation measures immediately after birth. Identifying preconception clinical and anamnestic risk factors for induced preterm labor due to placenta-associated complications allows for a differentiated approach to planning subsequent pregnancies.