Ukrainian Journal of Perinatology and Pediatrics. 2024.4(100): 51-55. doi: 10.15574/PP.2024.4(100).5155
Shevchuk O. V., Dubchak A. E., Tumanova L. E.
SI “Ukrainian center of maternity and childhood of the NAMS of Ukraine", Kyiv

For citation: Shevchuk OV, Dubchak AE, Tumanova LE. (2024). Endocrine-immune factors in patients of reproductive age with hyperproliferative diseases of the uterus against the background of the threat of early abortion. Ukrainian Journal of Perinatology and Pediatrics. 4(100): 51-55. doi: 10.15574/PP.2024.4(100).5155.Article received: Jul 26, 2024. Accepted for publication: Nov 27, 2024.

The main causes of adverse perinatal outcomes are miscarriage, placental dysfunction, gestosis, which are caused by hyperproliferative diseases of the uterus (HPD), past inflammatory diseases of the internal genital organs (IDIGO) and stress.
Aim – to study endocrine-immune factors in pregnant women with HPD and the threat of abortion in the first trimester of pregnancy.
Materials and methods. 64 pregnant women of reproductive age with HPD (uterine leiomyoma and adenomyosis) against the background of the threat of early abortion and past IDIGO before pregnancy (main group) were examined. The control group consisted of 30 pregnant women without HPD and no history of IDIGO. The cytokine profile was studied in the blood serum of pregnant women – TNFα, IFNγ, IL-8, IL-6, IL-4, the content of progesterone, prolactin and cortisol.
Results. In the first trimester of pregnancy, the average progesterone level in the main group was 13% lower than in the control group, which indicated a pronounced insufficiency of the function of the corpus luteum of pregnancy. An increase in cortisol and prolactin levels was also found, almost twice as high as in the control group (p<0.05). The TNFα/IL-4 ratio was almost 3 times higher than in the control group, and the IFNγ/IL-4 ratio was almost 2 times higher. IL-8 was increased in the main group almost twice as high, and IL-6 by 25.5% (p<0.05).
Conclusions. An increase in proinflammatory cytokines in pregnant women with HPD against the background of the threat of early abortion may indicate a shift in the cytokine profile in this pathology of pregnancy towards the inflammatory type and indicates a long course of IDIGO before pregnancy. Increased cortisol and prolactin may indicate a strain on the stress-realizing link of adaptive reactions in the conditions of martial law in Ukraine and may contribute to the threat of early abortion.
The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research.
The authors declare that there is no conflict of interest.
Keywords: pregnancy, hyperproliferative diseases of the uterus, leiomyoma, adenomyosis, endocrine-immune factors, threat of early abortion.

REFERENCES

1. ACOG. (2019). Fetal Growth Restriction. American College of Obstetricans and Gynecologists Committee on Practice Bulletins – Obstetrics and the Society for Maternal-Fetal Medicin. ACOG Practice Bulletin No.204. Obstet. Gynecol. 133(2): e97-e109. https://doi.org/10.1097/AOG.0000000000003070; PMid:30681542

2. Albonici L, Benvenuto M, Focaccetti C, Cifaldi L, Miele MT, Limana F et al. (2020, Nov 18). PlGF Immunological Impact during Pregnancy. Int J Mol Sci. 21(22): 8714. https://doi.org/10.3390/ijms21228714; PMid:33218096 PMCid:PMC7698813

3. Ancheva IA. (2017). Psychoprevention of stress during pregnancy and childbirth. Health Woman. 5(121): 32-41. https://doi.org/10.15574/HW.2017.121.32

4. Hedström J, Herder T. (2023, Dec 31). Woman's sexual and reproductive health in war and conflict: are we seeing the full picture? Health Action. 16(1): 2188689. https://doi.org/10.1080/16549716.2023.2188689; PMid:36927249 PMCid:PMC10026773

5. Kaminskyi AV, Kharun IL. (2023). Obgruntuvannia vzaiemozv'iazku ta «efektu zamknenoho tsyklu» mizh posttravmvtychnym stresovym rozladom ta zvychnym nevynoshuvanniam vahitnosti. Reproductive health of woman. 3(66): 18-23. https://doi.org/10.30841/2708-8731.3.2023.283319

6. Li D, Zheng L, Zhao D, Xu Y, Wang Y. (2021). The role of immune Cells in recurrent Spontaneous Abortion. Reprod Sci. 28(12): 3303-3015. https://doi.org/10.1007/s43032-021-00599-y; PMid:34101149 PMCid:PMC8186021

7. Magee LA, Von Dadelszen P, Stones W, Mathai M. (2016). The FIGO Textbook of Pregnancy Hypertension. London: The Global Library of WoMedicine,s Welfare of Women Global Health Programme: 434. URL: https://www.glowm.com/resource-type/resource/textbook/title/the-figo-textbook-of-pregnancy-hypertension/resource-doc/2768.

8. Mannini L, Sorbi F, Noci I. (2017). New adverse obstetrics outcomes associated with endometriosis: a retrospective cohort study. Arch Gynecol Obstet. 295(1): 141-151. https://doi.org/10.1007/s00404-016-4222-7; PMid:27770245

9. Morelli S, Mandal M, Goldsmith Lt, Kashani BN, Ponzio NM. (2015). The maternal immune system during pregnancy and its influence on fetal development. Res Rep Biol. 6: 171-189. https://doi.org/10.2147/RRB.S80652

10. Pérez-Roncero GR, López-Baena MT, Ornat L, Cuerva MJ, Garcia-Casarrubios P et al. (2020, Sep). Uterine fibroids and preterm birth risk: A systematic review and meta-analysis. J Obstet Gynaecol Res. 46(9): 1711-1727. Epub 2020 Jul 6. https://doi.org/10.1111/jog.14343; PMid:32633025

11. Sarkodie EK, Zhou S, Baidoo SA. (2019). Influences of stress hormones on microbial infections. Microbial Pathogenesis. 131: 270-276. https://doi.org/10.1016/j.micpath.2019.04.013; PMid:30981718

12. Tsymbaliuk VI. (2020). Obstetrics and Gynecology help to save women's reproductive health in armed conflicts (monohrafiia). Lviv: 71-81.

13. Wang W, Sung N, Gilman-Sach A, Kwak-Kim J, Helper T. (2020). (Th) Cell Profiles in Pregnancy and Recurrent Pregnancy Losses: Th1/Th2/Th9/Th17/Th22/ThCells. Front Immunol. 11: 2025. https://doi.org/10.3389/fimmu.2020.02025; PMid:32973809 PMCid:PMC7461801

14. Zaporozhan VM ta insh. (2014). Akusherstvo. T. 1. Akusherstvo ta hinekolohiia. Natsionalnyi pidruchnyk u 4 t. Za red. akad. NAMN Ukrainy, prof. V.M. Zaporozhana K.: VSV «Medytsyna»: 928.

15. Zaporozhan VM ta insh. (2014). Neoperatyvna hinekolohiia. T. 3. Akusherstvo ta hinekolohiia. Natsionalnyi pidruchnyk u 4 t. Za red. akad. NAMN Ukrainy, prof. V.M. Zaporozhana K.: VSV «Medytsyna»: 928.