Investigation of the plasma levels of il-ß, TNF-? and VEGF in early membrane rupture

Preterm delivery due to early membrane rupture (EMR) is one of the major etiologic factor of neonatal morbidity and mortality. The physiopathology of EMR is not clear yet. Recent studies indicates the relationship between preterm delivery and genital tract infection-inflammation via proinflammatory cytokines like tumor necrosis factor (TNF) and interleukin (IL) and angiogenic factors like vascular endothelial growth factor (VEGF). In this study, we aimed to investigate the relationship between EMR and maternal and cord blood plasma levels of TNF-alpha, IL-1beta and VEGF. This prospective, randomized, cross sectional study was conducted with 85 pregnant women attended Firat University Hospital Department of Obstetrics and Gynecology. The participants were divided into four groups according to their gestational age and amniotic membrane integrity. The mean age, number of gravida and gestational week of all participants were 28,2±5,9 years, 2,5±1,7 and 36±3,6 weeks respectively. The comparison of cytokine levels between EMR and non-EMR participants revealed out the following findings: IL-1beta levels were significantly low, but TNF-alpha levels were significantly high in maternal and cord plasma of EMR participants. There was no significant difference for VEGF. The comparison of cord and maternal plasma levels showed that cord plasma TNF-alpha levels were significantly high in EMR participants and cord plasma VEGF levels were significantly high in all participants. The influence of maternal age on cord plasma VEGF levels were minimal (RR=0,8, 95% CI= 10,6-13,04; p<0,01). In conclusion; higher TNF-alpha levels in our EMR participants indicates an inflammatory process during EMR. High cord plasma VEGF levels may point out placental or fetal production. Of course to discuss our results, new studies with expanded populations are needed. Key words: Premature rupture of membrane, preterm delivery, interleukin 1 beta, tumor necrosis factor alpha, vascular endothelial growth factor