Document Detail

Dysregulation of maternal serum adiponectin in preterm labor.
MedLine Citation:
PMID:  19579094     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Intra-amniotic and systemic infection/inflammation have been causally linked to preterm parturition and fetal injury. An emerging theme is that adipose tissue can orchestrate a metabolic response to insults, but also an inflammatory response via the production of adipocytokines, and that these two phenomenons are interrelated. Adiponectin, an insulin-sensitising, anti-inflammatory adipocytokine, circulates in multimeric complexes including low-molecular weight (LMW) trimers, medium-molecular weight (MMW) hexamers and high-molecular weight (HMW) isoforms. Each of these complexes can exert differential biological effects. The aim of this study was to determine whether spontaneous preterm labor (PTL) with intact membranes and intra-amniotic infection/inflammation (IAI) is associated with changes in maternal serum circulating adiponectin multimers.
STUDY DESIGN: This cross-sectional study included patients in the following groups: (1) normal pregnant women (n=158); (2) patients with an episode of preterm labor and intact membranes without IAI who delivered at term (n=41); (3) preterm labor without IAI who delivered preterm (n=27); and (4) preterm labor with IAI who delivered preterm (n=36). Serum adiponectin multimers (total, HMW, MMW and LMW) concentrations were determined by ELISA. Non-parametric statistics were used for analyses.
RESULTS: (1) Preterm labor leading to preterm delivery or an episode of preterm labor that does not lead to preterm delivery was associated with a lower median maternal serum concentration of total and HMW adiponectin, a lower median HMW/total adiponectin ratio and a higher median LMW/total adiponectin ratio than normal pregnancy; (2) among patients with preterm labor, those with IAI had the lowest median concentration of total and HMW adiponectin, as well as the lowest median HMW/total adiponectin ratio; (3) the changes in maternal adiponectin and adiponectin multimers remained significant after adjusting for confounding factors such as maternal age, BMI, gestational age at sampling and parity.
CONCLUSION: (1) Preterm labor is characterised by a change in the profile of adiponectin multimers concentrations and their relative isoforms. These changes were observed in patients with an episode of preterm labor not leading to preterm delivery, in patients with intra-amniotic inflammation, or in those without evidence of intra-amniotic inflammation. (2) The changes in adiponectin multimer concentrations reported in preterm labor are different from those previously reported in spontaneous labor at term, suggesting that there is a fundamental difference between preterm labor and labor at term. (3) The findings reported herein provide the first evidence for the participation of adiponectin multimer in preterm parturition. We propose that adiponectins and adipokines in general provide a mechanism to organise the metabolic demands generated by the process of preterm parturition regardless of the nature of the insult (intra-amniotic inflammation or not).
Shali Mazaki-Tovi; Roberto Romero; Edi Vaisbuch; Offer Erez; Pooja Mittal; Tinnakorn Chaiworapongsa; Sun Kwon Kim; Percy Pacora; Lami Yeo; Francesca Gotsch; Zhong Dong; Chia-Ling Nhan-Chang; Cristiano Jodicke; Bo Hyun Yoon; Sonia S Hassan; Juan Pedro Kusanovic
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  22     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-16     Completed Date:  2010-02-08     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  887-904     Citation Subset:  IM    
Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, HutzelWomen's Hospital, Bethesda, Maryland, USA.
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MeSH Terms
Adiponectin / blood,  metabolism
Chorioamnionitis / blood,  metabolism
Cross-Sectional Studies
Fetal Membranes, Premature Rupture / blood,  metabolism
Obstetric Labor, Premature / blood*,  metabolism
Osmolar Concentration
Pregnancy Trimester, Third / blood,  metabolism
Premature Birth / blood,  metabolism
Protein Multimerization
Young Adult
Grant Support
Reg. No./Substance:
0/ADIPOQ protein, human; 0/Adiponectin

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