The Role of Maternal Stress, Cortisol and Interleukin-12 in Cases of Missed Abortion in the First Trimester of Pregnancy in Saudi Women


The Role of Maternal Stress, Cortisol and Interleukin-12 in Cases of Missed Abortion in the First Trimester of Pregnancy in Saudi Women


Khulood S. Husseina*

aDepartment of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA


American Journal of Anatomy and Physiology 2D

Missed abortion in early pregnancy is a common gynecological condition, and the incidence has been increasing presenting itself as a public health problem. This study aimed to examine stress, cortisol concentration, and altered IL-12 levels in women who experienced missed abortions. Women with missed abortions (n = 40) were matched with control women of the same age in the same stage of pregnancy (n = 30). Participants filled out a survey about common stress factors. Venous blood samples were taken from the patients at 7:00 a.m. ELISA detected IL-12 concentrations, and serum cortisol was measured by electrochemiluminescence immunoassay. Women with missed abortions reported significantly more common stressors, and their serum cortisol and IL-12 concentrations were significantly higher than those of the women with healthy pregnancies (all P< 0.05). Receiver operating characteristic (ROC) analysis was used to assess the power of the studied parameters to predict women at risk for missed abortion. IL-12 performed the best in predicting women with missed abortions as it had the highest area under the curve (AUC), followed by cortisol. Stress and changes in the immune system may play a role in the etiology of missed abortion in Saudi women in early pregnancy.


Keywords: Stress marker, Cortisol, IL-12, Missed abortion, Saudi women, Early pregnancy.

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How to cite this article:
Khulood S. Hussein. The Role of Maternal Stress, Cortisol and Interleukin-12 in Cases of Missed Abortion in the First Trimester of Pregnancy in Saudi Women. Hussein.American Journal of Anatomy and Physiology, 2019, 2:6


References:

1. Chen H, Deng X, Yang Y, Shen Y, et al. Expression of GRIM-19 in missed abortion and possible pathogenesis. Fertil Steril 2015; 103(1):138-146.e3.
2. Bai FL. 2008. Cause exploration of missed abortion. Chinese Journal of Reproductive Health 19:377–379.
3. Cheng X, Wu XH, Li Z, Yang Y. 2009. Analysis of emotional disorder and coping style on patients of missed miscarriage. Chongqing Medicine 38:643–645.
4. Xiao YN, Tao FB. 2008. Gestational psychologic stress on pregnancy outcome and children development. Journal of Applied Clinical Pediatrics 23:226–228.
5. Cohen S, Kessler RC, Gordon LU. Strategies for measuring stress in studies of psychiatric and physical disorders. In: Cohen S, Kessler RC, Gordon LU, editors. Measuring stress: a guide for health and social scientists. Oxford: Oxford University Press; 1995. p.3.
6. Woods SM, Melville JL, Guo Y, Fan MY, Gavin A. Psychosocial stress during pregnancy. Am J Obstet Gynecol. 2010 Jan; 202(1):61.e1-7.
7. Huizink AC, Robles de Medina PG, Mulder EJ, et al. Stress during pregnancy is associated with developmental outcome in infancy. J Child Psychol Psychiatry. 2003 Sep; 44(6):810-818.
8. O’Hare T, Creed F. Life events and miscarriage. Br J Psychiatry. 1995;167(6):799-805.
9. Boyles SH, Ness RB, Grisso JA, et al. Life event stress and the association with spontaneous abortion in gravid women at an urban emergency department. Health Psychol. 2000;19(6):510-514.
10. Kicia M, Skurzak A, Wiktor K, Iwanowicz-Palus G, Wiktor H. Anxiety and stress in miscarriage. Pol J Public Health. 2015;125:162–165.
11. Maconochie N, Doyle P, Prior S, Simmons R. Risk factors for first trimester miscarriage–results from a UK-population-based case-control study. BJOG. 2007; 114(2):170-186.
12. Gao Y, Yang YF. 2005. The effect of social and psychological stress during pregnancy on psychological and behavioral development of offspring. Journal of Applied Clinical Pediatrics 20:480–482.
13. Han L, Yang HL. 2009. Th1-type, Th2-type cytokines and pregnancy and pregnancy complications. Maternal and Child Health Care of China 24:5249–5252.
14. Hamza T, Barnett JB, Li B. 2010. Interleukin 12 a key immunoregulatory cytokine in infection applications. International Journal of Molecular Sciences 11:789–806.
15. Paradisi R, Porcu E, Venturoli S, Maldini-Casadei M, Boni P. 2003. Maternal serum levels of pro-inflammatory cytokines in missed and threatened abortion. American Journal of Reproductive Immunology 50:302–308.
16. Cao WP, Qian QJ, Fan J. 2008. Study on mechanism of immunoregulatory role in the pathogenesis of pregnancy induced missed abortion. Maternal and Child Health Care of China 23:246–248.
17. Zhang LY, Su JX, Wang TY. 2009. Balance between glucocorticoids with the Th1/Th2. Chinese Journal of Allergy and Clinical Immunology 3: 58–61.
18. Chaaya M, Osman H, Naassan G, Mahfoud Z. Validation of the Arabic version of the Cohen Perceived Stress Scale (PSS-10) among pregnant and postpartum women. BMC Psychiatry. 2010 Dec 15; 100:111.
19. Zhai HM, Li YJ. 2005. Research progress on stress reaction evaluation. Chinese Nursing Research 19:1131–1133.
20. Tian CF & Kang MH. 2013. Common stress and serum cortisol and IL-12 levels in missed abortion, Journal of Obstetrics and Gynaecology, 34:1, 33-35.
21. O’Connor TM, O’Halloran DJ, Shanahan F. The stress response and the hypothalamic‐pituitary‐adrenal axis: from molecule to melancholia, QJM: An International Journal of Medicine, Volume 93, Issue 6, 1 June 2000, Pages 323–333.
22. Robles TF and Kane HS. 2014. The attachment system and physiology in adulthood: normative processes, individual differences, and implications for health. J Pers, 82(6):515-27.
23. Costa-Martins JM, Moura-Ramos M, Cascais MJ, et al. 2016. Adult attachment style and cortisol responses in women in late pregnancy. BMC Psychology; 4(1):1.
24. Li P, Guo XY. 2006. Progress in study on mechanisms of stress’s influence on female’s reproductive endocrine function. Chinese Journal of Maternal and Child Health Research 17:215–217.
25. Wu ZF. 2006. Investigation and analysis of 295 cases of missed abortion. Public Medical Forum Magazine 17:215–217.
26. Littleton HL, Breitkopf CR, Berenson AB. Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis. Am J Obstet Gynecol. 2007; 196(5):424-32.
27. Maconochie N, Doyle P, Prior S, Simmons R. 2007. Risk factors for first trimester miscarriage results from a UK-population-based case-control study. British Journal of Obstetrics and Gynaecology 114:170–186.
28. Liu WL, Xia LJ. 2009. IL-12 and IL-4 expressions in nasal polyps. Journal of Otolaryngology and Ophthalmology of Shandong University 23:63–65.
29. Ostojic S, Volk M, Medica I, et al. 2007. Polymorphisms in the Interlukin 12/18 Genes and Recurrent Spontaneous Abortion. Am J Reprod Immunol; 58(5):403-408.
30. Kanchana A and Girijavani DSS. Fibrinogen levels helps in early detection of abnormal pregnancies. Intl J Reproduction, Contraception, Obstetrics and Gynecology 2017;6(1):232-239.
31. Mollamahmutoğlu L, Kalyoncu S, Engin-Ustün Y, et al. Troponin I, C-reactive protein and fibrinogen levels in missed abortions. Clin Exp Obstet Gynecol. 2011;38(1):60-62.
32. Parasnis H, Raje B, Hinduja I N. Relevance of plasma fibrinogen estimation in obstetric complications. J Postgrad Med 1992;38:183.