Variable expression of soluble fms-like tyrosine kinase 1 in patients at high risk for preeclampsia

Objective.?To explore angiogenic factor differences in preeclamptic patients according to the absence or presence of underlying vascular disease.

Methods.?We prospectively compared serum soluble fms-like tyrosine kinase 1 (sFlt1), soluble endoglin, and placental growth factor (PlGF) from 41 normal-risk and 32 high-risk (preexisting conditions) subjects at serial gestational ages.

Results.?Median sFlt1 was lower at delivery in preeclamptic patients with underlying chronic hypertension and/or chronic proteinuria (5115?pg/ml) compared with normal risk preeclamptic patients (16375?pg/ml). PlGF was consistently low in patients who developed preeclampsia.

Conclusions.?Effects of sFlt1 may be contextual, varying according to the health or disease state of vascular endothelium.     

The use of angiogenic biomarkers in maternal blood to identify which SGA fetuses will require a preterm delivery and mothers who will develop pre-eclampsia

Objective: To determine (1) whether maternal plasma concentrations of angiogenic and anti-angiogenic factors can predict which mothers diagnosed with “suspected small for gestational age fetuses (sSGA)” will develop pre-eclampsia (PE) or require an indicated early preterm delivery (≤?34 weeks of gestation); and (2) whether risk assessment performance is improved using these proteins in addition to clinical factors and Doppler parameters.

Methods: This prospective cohort study included women with singleton pregnancies diagnosed with sSGA (estimated fetal weight <10th percentile) between 24 and 34 weeks of gestation (n?=?314). Plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), soluble endoglin (sEng) and placental growth factor (PlGF) were determined in maternal blood obtained at the time of diagnosis. Doppler velocimetry of the umbilical (Umb) and uterine (UT) arteries was performed. The outcomes were (1) subsequent development of PE; and (2) indicated preterm delivery at ≤34 weeks of gestation (excluding deliveries as a result of spontaneous preterm labor, preterm pre-labor rupture of membranes or chorioamnionitis).

Results: (1) The prevalence of PE and indicated preterm delivery was 9.2% (n?=?29/314) and 7.3% (n?=?23/314), respectively; (2) the area under the receiver operating characteristic curve (AUC) for the identification of patients who developed PE and/or required indicated preterm delivery was greater than 80% for the UT artery pulsatility index (PI) z-score and each biochemical marker (including their ratios) except sVEGFR-1 MoM; (3) using cutoffs at a false positive rate of 15%, women with abnormal plasma concentrations of angiogenic/anti-angiogenic factors were 7–13 times more likely to develop PE, and 12–22 times more likely to require preterm delivery than those with normal plasma MoM concentrations of these factors; (4) sEng, PlGF, PIGF/sEng and PIGF/sVEGFR-1 ratios MoM, each contributed significant information about the risk of PE beyond that provided by clinical factors and/or Doppler parameters: women who had low MoM values for these biomarkers were at 5–9 times greater risk of developing PE than women who had normal values, adjusting for clinical factors and Doppler parameters (adjusted odds ratio for PlGF: 9.1, PlGF/sEng: 5.6); (5) the concentrations of sVEGFR-1 and PlGF/sVEGFR-1 ratio MoM, each contributed significant information about the risk of indicated preterm delivery beyond that provided by clinical factors and/or Doppler parameters: women who had abnormal values were at 8–9 times greater risk for indicated preterm delivery, adjusting for clinical factors and Doppler parameters; and (6) for a two-stage risk assessment (Umb artery Doppler followed by Ut artery Doppler plus biochemical markers), among women who had normal Umb artery Doppler velocimetry (n?=?279), 21 (7.5%) developed PE and 11 (52%) of these women were identified by an abnormal UT artery Doppler mean PI z-score (>2SD): a combination of PlGF/sEng ratio MoM concentration and abnormal UT artery Doppler velocimetry increased the sensitivity of abnormal UT artery Doppler velocimetry to 76% (16/21) at a fixed false-positive rate of 10% (p?=?0.06).

Conclusion: Angiogenic and anti-angiogenic factors measured in maternal blood between 24 and 34 weeks of gestation can identify the majority of mothers diagnosed with “suspected SGA” who subsequently developed PE or those who later required preterm delivery ≤34 weeks of gestation. Moreover, incorporation of these biochemical markers significantly improves risk assessment performance for these outcomes beyond that of clinical factors and uterine and umbilical artery Doppler velocimetry.     

Complexity of parental prenatal attachment during pregnancy at risk for preterm delivery

Objective: To clarify the links between parents’ prenatal attachment and psychosocial perinatal factors such as maternal depression, anxiety and social support.

Methods: Cross-sectional study including 43 couples with high-risk pregnancy (RP) and 37 with physiologic pregnancy (PP). Self-report measures (depression, anxiety, social support and prenatal attachment) are completed by mothers, prenatal attachment questionnaire by fathers.

Results: Depression (p?<?0.001) and state anxiety (p?<?0.001) are higher in RP. Both, maternal and paternal antenatal attachment is significantly lower in RP (p?<?0.001; p?<?0.005) but not related to depression or anxiety. Paternal antenatal attachment is strictly related to the maternal attachment scale in both groups (PP: r?<?0.034; RP: r?<?0.004) and paternal antenatal scores in RP have a negative significant correlation with mothers’ depression (r?<?0.095).

Conclusion: Hospitalized expecting parents at risk of preterm delivery develop less attachment to the fetus and higher levels of anxiety and depression compared to the physiologic pregnancy group. Maternal antenatal attachment is an independent variable related to the diagnosis of a possible preterm delivery. The promotion of prenatal psychological well-being and attachment for future mothers and fathers may serve to improve maternal health practices, perinatal health and neonatal outcome.     

Prognostic value of serum soluble FMS-like tyrosine kinase (sFlt-1) levels in pre-eclampsia and eclampsia; a prospective cohort study

Objective: To evaluate the levels of circulating sFlt-1 in pre-eclampsia (PE) and eclampsia patients and to assess its prognostic value in detection of PE complications. Methods: The present study was a prospective cohort study conducted in tertiary hospital between January and December 2016. Included patients were divided into two groups; (Group I) severe PE group and (Group II) eclampsia group. Age-, parity-, and gestational age-matched women had approached to participate in the study as a control group (Group III). Serum sFlt-1 levels were measured at inclusion and 2 days later with all basic investigations. Patients were followed up until delivery to record any complications. Correlation analysis was performed between the serum sFlt-1 levels and clinical, laboratory investigations. Receiver operating characteristic analysis was constructed for the evaluation of the area under curve (AUC) as well as the sensitivity and specificity regarding the cutoff point of sFlt-1 level that predict occurrence of complications. Results: The study included 84 women. Women with complicated severe PE showed higher sFlt-1 levels than in non-complicated cases (120.2 ± 19.6 versus 72.2 ± 19.6, p < 0.001). Similarly, the mean serum level of sFlt-1 in complicated eclampsia was higher than in non-complicated cases (298.3 ± 75.2 versus 128.1 ± 36.5, p < 0.001) (OR = 1.119, 95% CI: 10.057–1.184, p < 0.001). SFlt-1 levels were strongly correlated with systolic blood pressure (r = 0.641) and diastolic blood pressure (r = 0.540) (p < 0.001 and p < 0.001, respectively). At cutoff point 102.60 ng/ml of sFlt-1 levels, the sensitivity was 90% and specificity was 80% with AUC = 0.923, 95% CI: 0.871–0.975. Conclusions: Serum sFlt-1 can be used as a prognostic marker to predict the occurrence of complications of preeclampsia.     

Association between the high soluble fms-like tyrosine kinase-1 to placental growth factor ratio and adverse outcomes in asymptomatic women with early-onset fetal growth restriction

Objective: To assess whether the high soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio is associated with adverse outcomes (e.g., HELLP syndrome [hemolysis, elevated liver enzymes, and low platelets], severe hypertension uncontrolled by medication, non-reassuring fetal status, placental abruption, pulmonary edema, growth arrest, maternal death, or fetal death) and a shorter duration to delivery in early-onset fetal growth restriction (FGR).Methods: Thirty-four women with FGR diagnosed at <34.0 weeks were recruited. Serum angiogenic marker levels were estimated within 6 hours of a diagnosis of FGR. A receiver operating characteristic curve was used to determine the threshold of the sFlt-1/PlGF ratio to predict adverse outcomes. We used multivariable logistic regression analysis to examine the association between the sFlt-1/PlGF ratio and adverse outcomes. Finally, we used Kaplan-Meier analysis and the log-rank test to assess the probability of delay in delivery.

Results: Women who developed adverse outcomes within a week had a significantly higher sFlt-1/PlGF ratio than did those who did not develop complications. A cutoff value of 86.2 for the sFlt-1/PlGF ratio predicted adverse outcomes, with a sensitivity and specificity of 77.8% and 80.0%, respectively. Moreover, 58.4% of women with an sFlt-1/PlGF ratio ≥86.2 versus 9.1% of those with an sFlt-1/PlGF ratio <86.2 delivered within a week of presentation (p < 0.001). In multivariate analyses, an sFlt-1/PlGF ratio ≥86.2 (adjusted odds ratio 9.52; 95% confidence interval, 1.25–72.8) was associated with adverse maternal and neonatal outcomes.

Conclusion: A high sFlt-1/PlGF ratio was associated with adverse outcomes and a shorter duration to delivery in early-onset FGR.     

Maternal exercise during pregnancy reduces the risk of preterm birth through the mediating role of placenta

Objective: The extent of research on maternal exercise during pregnancy and the risk of preterm birth (PTB) have grown substantially, but conclusions still remained controversial. Thus, this study aims to examine the relationship of maternal exercise during pregnancy and PTB and explore whether placenta mediates their relationship.

Study design: We investigated 849 pregnant women delivering PTB newborns (cases) and 1306 delivering full-term appropriate for gestational age newborns (controls) in this case–control study. Information concerning maternal exercise during pregnancy, sociodemographics and obstetric characteristics were collected at Women and Children’s Hospitals of Shenzhen and Foshan in Guangdong, China. A series of logistic and linear regressions were used to examine the relationships of maternal exercise during pregnancy, placenta, and PTB.

Results: After adjusting for the potential confounders, maternal exercise frequency and duration during pregnancy were negatively associated with PTB. Moreover, compared with mother taking no exercise during pregnancy, those taking exercise lowered the risk of PTB except those taking low/medium frequency and short duration exercise, and their adjusted ORs ranged from 0.43 to 0.65. Furthermore, mediation analysis illustrated that placental weight partially mediated 65.20% of the effects of maternal exercise frequency on PTB, as well as 41.98% of the association between maternal exercise duration and PTB.

Conclusions: Maternal exercise during pregnancy is beneficial for lowering the risk of PTB, especially when taking appropriate and enough exercise. Placenta weight may partially mediate the association between maternal exercise during pregnancy and PTB.     

The effect of supine positioning on maternal hemodynamics during late pregnancy

Abstract

Introduction: Recent studies have demonstrated an association between maternal supine sleep position and an increased risk of late stillbirth. During late pregnancy, the gravid uterus compresses the inferior vena cava (IVC) when a woman lies in the supine position. The azygos system of veins is the dominant pathway of collateral venous return back to the heart in the event of acute obstruction of the IVC. It is suggested that this pathway provides adequate collateral venous circulation in the event of IVC compression in the supine position during late pregnancy.

Objective: Investigate the effect of supine positioning on maternal hemodynamics during late pregnancy and the role of collateral venous circulation.

Methods: Ethics approval was obtained and 12 women with singleton pregnancies between 35- and 38-week gestation underwent magnetic resonance imaging in the supine and left lateral decubitus positions using a Skyra 3T system (Siemens). Phase-contrast images were evaluated to measure cardiac output, blood flow through the azygos vein, and blood flow through the abdominal aorta (AA) and IVC at two levels: at the level of aortic bifurcation and immediately above the renal veins.

Results: The supine position was associated with a 16.4% reduction in cardiac output when compared to the left lateral position. In addition, blood flow through the IVC decreased at its origin by 85.3% and by 44.4% at the level of the renal veins. Blood flow through the azygos vein increased in the supine position by 220%. Blood flow through the AA at the level of the renal veins did not differ significantly; however, it is reduced by 32.3% at the level of the aortic bifurcation.

Conclusions: Women in late pregnancy experience an increase in collateral venous blood flow when lying supine, likely as a response to marked compression of the IVC in this position. However, cardiac output and aortic blood flow were found to decrease while in the supine position.     

人巨细胞病毒活动性感染对早孕绒毛细胞ERK1/2蛋白活性的影响

目的人巨细胞病毒（human cytomegalovirus,HCMV）活动性感染对早孕绒毛细胞外信号调节激酶（extracellular signal regulated kinase1/2,ERK1/2）的信号通路的影响,探讨HCMV宫内感染的可能机制。方法选取既往有异常妊娠史并行人工流产术的早孕妇女139例,应用逆转录-聚合酶链反应技术检测其胎盘绒毛组织HCMV-mRNA的表达;酶联免疫吸附试验法测定其血清HCMV-IgM;免疫印迹法及免疫组化法检测其ERK1/2活性及蛋白表达水平并进行半定量分析。结果139例孕妇中有15例胎盘绒毛组织HCMV-mRNA阳性,32例血清HCMV-IgM阳性,阳性率为23.0%（32/139）。依据HCMV-mRNA与HCMV-IgM检测结果,139例孕妇分为3组：A组：HCMV-mRNA与HCMV-IgM均阳性14例,其宫内传播率为43.8%（14/32）;B组：HCMV-mRNA阴性而HCMV-IgM阳性18例;C组：HCMV-mRNA与HCMV-IgM均阴性106例。另有1例HCMV-IgM阴性者其胎盘绒毛组织HCMV2mRNA阳性;②在所有标本绒毛组织中均可见总ERK1/2的表达,主要位于细胞滋养细胞的胞浆中,三组中总ERK1/2表达相似,但A组pERK1/2的表达强度明显高于B组,B组与C组无明显的差异;A组与B组和C组pERK1与pERK2比较,差异有统计学意义（P〈0.01,P〈0.05）。结论ERK1/2的信号通路可能在HCMV宫内活动性感染中起重要作用。     

The mediating role of placenta in the relationship between maternal exercise during pregnancy and full-term low birth weight

Objective: To explore the association of maternal exercise during pregnancy with full-term low birth weight (FT-LBW) and whether placenta mediates their association.

Study design: We investigated 326 pregnant women delivering FT-LBW weight newborns (cases) and 1644 delivering full-term normal birth weight newborns (controls) in this case-control study. Information concerning maternal exercise during pregnancy, socio-demographics and obstetric characteristics were collected at Women and Children’s Hospitals of Shenzhen and Foshan in Guangdong, China.

Results: After adjusting for the potential confounders, maternal exercise frequency and duration during pregnancy were significantly negatively associated with FT-LBW, respectively. Moreover, compared with mothers taking no exercise during pregnancy, those taking exercises were significantly negatively associated with FT-LBW except those taking low/medium frequency and short duration exercise and high-frequency and long duration exercise, and their adjusted ORs ranged from 0.30 to 0.62. Furthermore, mediation analysis illustrated that placental weight partially mediated 27.20% of the association between maternal exercise frequency during pregnancy and FT-LBW, but not the association between maternal exercise duration during pregnancy and FT-LBW.

Conclusions: Maternal exercise during pregnancy is beneficial for lowering FT-LBW risk, especially when taking appropriate and enough exercise. Placenta weight partially mediates the association between maternal exercise frequency during pregnancy and FT-LBW.     

The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study

Please cite this paper as: Awwad J, Usta I, Succar J, Musallam K, Ghazeeri G, Nassar A. The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG 2012;119:1379-1386. Objective To determine the effect of fasting during the month of Ramadan on the rate of preterm delivery (PTD). Design A prospective cohort study of women with singleton pregnancies who elected to fast and matched controls. Setting Four medical centres in Beirut, Lebanon. Population Women presenting for prenatal care (20-34?weeks of gestation) during the month of Ramadan, September 2008. Methods Data were collected prospectively. The frequency of PTD was evaluated in relation to the duration of fasting and the stage of gestation at the time of fasting. Main outcome measures The primary endpoint was the percentage of pregnant women who had PTD, defined as delivery before 37 completed weeks of gestation. Results A total of 468 women were approached, of whom 402 were included in the study. There were no differences in smoking history and employment. There was no difference in the proportion of women who had PTD at <37?weeks (10.4% versus 10.4%) or PTD at <32?weeks (1.5% versus 0.5%) in the Ramadan-fasted group and the controls, respectively. The PTD rate was also similar in those who fasted before or during the third trimester. The mean birthweight was lower (3094?±?467?g versus 3202?±?473?g, P?=?0.024) and the rate of ketosis and ketonuria was higher in the Ramadan-fasted women. On multivariate stepwise logistic regression analysis, fasting was not associated with an increased risk of PTD (odds ratio 0.72; 95% confidence interval 0.34-1.54; P?=?0.397). The only factor that had a significant effect on the PTD rate was body mass index (odds ratio 0.43; 95% confidence interval 0.20-0.93; P?=?0.033). Conclusions Fasting during the month of Ramadan does not seem to increase the baseline risk of preterm delivery in pregnant women regardless of the gestational age during which this practice is observed.     

Maternal and fetal IL1RN polymorphisms and the risk of preterm delivery: a meta-analysis

Objective: The aim of this study is to assess the relationship between IL1RN*2 variants and preterm delivery (PTD) risk.

Methods: Eligible studies were searched in Embase and PubMed databases from inception to November 2013. Two investigators identified relevant studies and extracted data of maternal and fetal genotype independently. Based on the evidence of functional studies, we used the dominant model to all compared studies.

Results: To maternal genotype, 269 PTDs and 688 controls were included in meta-analysis. The overall combined odds ratio for the IL1RN*2 variant and PTD was 1.91 (95% CI, 1.41–2.58). To fetal genotype, five studies of 322 PTDs and 858 term controls were included. The result for fetal genotype analysis showed increased risk of PTD, but not significantly (OR 1.33, 95% CI 0.99–1.78).

Subgroup analysis indicated that both maternal and fetal carriage of IL1RN*2 increased the risk of PTD only in studies including preterm premature rupture of membranes (PPROM), with a pooled OR 2.02 (95% CI 1.44–2.85) and 1.42 (1.02–1.99), respectively.

Conclusions: This meta-analysis suggests that maternal carriage of IL1RN*2 were associated with increased risk in PTD. PPROM may be an important confounding factor that should be taken into consideration for study of IL1RN polymorphism and PTD.     

The effect of cigarette smoking during pregnancy on mode of delivery in uncomplicated term singleton pregnancies

Abstract

Objective: To examine the influence of cigarette smoking during pregnancy on mode of delivery.

Methods: A retrospective analysis of 6105 uncomplicated term singleton pregnancies for mode of delivery was performed with respect to smoking status.

Results: Of all, 680 (84.0%) smokers and 4588 (86.7%) non-smokers had a spontaneous vaginal delivery, 65 (8.0%) smokers and 393 (7.4%) non-smokers had an instrumental delivery and 65 (8.0%) smokers and 314 (5.9%) non-smokers had a cesarean delivery (p?=?0.051). Smoking during pregnancy increased the risk of any operative or instrumental intervention by OR 1.240, 95% CI 1.012–1.523. Non-reassuring fetal heart rate pattern that warranted either cesarean or instrumental intervention was present in 99 (12.2%) out of 810 smokers and in 392 out of 5295 (7.4%) non-smokers, p?<?0.001). Smoking during pregnancy increased the risk of non-reassuring fetal heart rate pattern that warranted either cesarean or instrumental intervention by OR 1.650 (95% CI 1.341–2.022).

Conclusion: Women with uncomplicated term singleton pregnancies who smoke during pregnancy are at an increased risk of fetal compromise during labor (as judged by non-reassuring fetal heart rate pattern), leading to increased rates of operative delivery (cesarean either instrumental).     

Influence of amino acid administration on serum concentrations of pregnancy-specific proteins SP-1 and HPL during last trimester of pregnancy

For further clarification of factors influencing the releasing mechanism of the placental proteins SP-1 and HPL a mixture of amino acids was given to pregnant women in the last trimester of gestation.During 48 h following the beginning of amino acid administration no significant changes of mean serum levels of SP-1 and HPL were observed.     

Circulating anti-angiogenic factors during hypertensive pregnancy and increased risk of respiratory distress syndrome in preterm neonates

Objective: To test the hypothesis that high circulating concentrations of maternal anti-angiogenic factors are associated with increased risk of respiratory distress syndrome (RDS). Study Design: This is a nested case-control study of nulliparous women who delivered less than 37 weeks of gestation within the Calcium for Preeclampsia Prevention (CPEP) trial. The study included 116 women with preeclampsia or gestational hypertension and 323 normotensive controls. Soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF) and soluble endoglin (sEng) in maternal serum were measured at 21–32 weeks of gestation. Results: Preterm infants born to hypertensive mothers were more likely to develop RDS (22.5% vs. 20.9%, p?=?0.03). After adjustment for gestational age at delivery, the odds ratio for the relationship between hypertension in pregnancy and RDS was 2.18 (95% CI 1.08–4.39). In hypertensive pregnancies women whose infants developed RDS had significantly higher circulating mean sFlt1 levels during midpregnancy (21–32 weeks of gestation) even after adjustment for gestational age at delivery (21,516 pg/mL vs. 7,000 pg/mL, p?=?0.01). Conclusions: Preterm preeclampsia and gestational hypertension, characterized by high circulating levels of sFlt1, are associated with a twofold increased risk of RDS in infants delivered before 37 weeks. Among women with these hypertensive pregnancies circulating sFlt1 concentrations during midpregnancy were substantially higher in women whose infants developed RDS.     

Trends,seasonality and effect of ambient temperature on preterm delivery

Purpose: To identify trends in preterm delivery (PTD) as well as seasonality, temporal variation and the effect of heat stress on its incidence.

Materials and methods: In this retrospective population-based study, we included all deliveries taking place at the Soroka University Medical Center between the years 1988–2012. A time series database was built including meteorological factors and the number of spontaneous versus induced PTDs for each day. Data were analyzed using time–series analyses.

Results: During the study period, 263 709 deliveries occurred, 7.9% of which were preterm. Spontaneous PTD rate steadily decreased, while induced PTD rate increased. A significant annual and seasonal variation was noted in PTD incidence. A significant higher incidence of spontaneous PTD was demonstrated during the summer period with an incidence rate ratio (IRR) of 4.1 (95%CI: 3.1–5.5; p?p?Conclusions: Spontaneous PTD is more common during the summer and its rate is declining steadily over the past decades. Increased outdoor temperature has a significant effect on the incidence of spontaneous, but not induced, PTD.     

尼古丁通过抑制可溶性血管内皮生长因子受体1促进胎盘生长因子分泌并提高人滋养细胞侵袭行为的分子机制

目的:探讨尼古丁对人滋养细胞侵袭行为调控的分子机制。方法:以低剂量尼古丁处理人绒毛膜癌细胞株JEG-3,以实时定量RT-PCR及ELISA方法分析可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase 1,s Flt1)及胎盘生长因子(placental growth factor,PLGF)在m RNA及蛋白质水平的表达。以PLGF阻断性抗体及尼古丁共同处理人滋养细胞,Transwell细胞侵袭实验分析滋养细胞的侵袭能力。结果:低剂量的尼古丁通过抑制s Flt1表达促进PLGF分泌并改善滋养细胞的侵袭能力。结论:尼古丁可能通过调控滋养细胞PLGF分泌改善滋养细胞的侵袭行为,对妊娠高血压综合征(PIH)发挥保护作用。     

宫颈扩张过程中单核细胞趋化蛋白-1表达的意义

目的:观察单核细胞趋化蛋白-1(MCP-1)在分娩期宫颈扩张不同程度时母血、子宫肌层组织和胎盘组织中的表达,探讨MCP-1在宫颈扩张过程中的作用。方法:选择临产后急诊行剖宫产终止妊娠的初产妇42例,根据术前30min宫颈扩张程度分为A组10例(宫颈口开大<2cm),B组10例(宫颈口开大2~4cm),C组10例(宫颈口开大4~6cm),D组12例(宫颈口开大>6cm)。酶联免疫吸附法测定产妇血清中MCP-1水平;用半定量RT-PCR法测定子宫下段肌层及胎盘组织中MCP-1mRNA的表达。结果:C组和D组血清MCP-1水平和组织中MCP-1mRNA含量显著高于A组和B组(P<0.01),B组组织中MCP-1mRNA含量显著高于A组(P<0.05);4组产妇MCP-1的表达量与宫颈扩张程度呈正相关。结论:MCP-1在宫颈扩张过程中表达增加,在宫颈扩张过程中起重要作用。