Maternal plasma visfatin in preterm labor

Abstract

Objective: Visfatin, a novel adipokine with diabetogenic and immunoregulatory properties, has been implicated in the pathophysiology of insulin resistance, as well as in various acute and chronic inflammatory disorders. We have previously reported that amniotic fluid concentrations of visfatin are higher in patients with preterm labor (PTL) and intra-amniotic infection than in patients with PTL without infection. The aim of this study was to determine whether spontaneous PTL with intact membranes and intra-amniotic infection/inflammation (IAI) is associated with changes in maternal plasma circulating visfatin concentrations.

Study design: This cross-sectional study included patients in the following groups: (1) normal pregnant women (n = 123); (2) patients with an episode of PTL and intact membranes without IAI who delivered at term (n = 57); (3) PTL without IAI who delivered preterm (n = 47); and (4) PTL with IAI who delivered preterm (n = 57). Plasma visfatin concentrations were determined by ELISA. Non-parametric statistics were used for analysis.

Results: (1) PTL with IAI leading to preterm delivery was associated with a higher median maternal plasma concentration of visfatin than normal pregnancy; (2) among patients with PTL, those with IAI had the highest median maternal concentration of visfatin; (3) the changes in maternal plasma visfatin remained significant after adjusting for maternal age, body mass index, gestational age at sampling, and birth weight.

Conclusion: (1) PTL with IAI is characterized by high maternal circulating visfatin concentrations; (2) these findings suggest that visfatin plays a role in the regulation of the metabolic adaptations to insults resulting in PTL in the context of IAI.

Figure 1. Comparison of the median maternal plasma visfatin between women with normal pregnancies and patients with spontaneous PTL.

The median maternal plasma visfatin concentration was higher in patients with preterm labor with IAI than those with preterm labor without IAI who delivered either preterm or at term. Similarly, the median maternal plasma visfatin concentration was higher in patients with preterm labor with IAI than those with a normal pregnancy. The median maternal plasma visfatin concentration did not differ significantly between patients with preterm labor without IAI who delivered preterm and those who delivered at term. In addition, there was no significant difference in the median maternal plasma visfatin concentration between women with a normal pregnancy and those with preterm labor without IAI who delivered either preterm or at term.