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Sequential disruptions to inflammatory and angiogenic pathways and risk of spontaneous preterm birth in Malawian women

Weckman, Andrea M., Elphinstone, Robyn E., Ssenkusu, John M., Tran, Vanessa, Zhong, Kathleen, Madanitsa, Mwayiwawo, Khairallah, Carole, Kalilani-Phiri, Linda, Mwapasa, Victor, Conroy, Andrea L., terKuile, Feiko ORCID:, Mcdonald, Chloe R. and Kain, Kevin C. (2023) 'Sequential disruptions to inflammatory and angiogenic pathways and risk of spontaneous preterm birth in Malawian women'. iScience, Vol 26, e106912.

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Preterm birth is a leading cause of death in children under five years of age. We hypothesized that sequential disruptions to inflammatory and angiogenic pathways during pregnancy increase the risk of placental insufficiency and spontaneous preterm labour and delivery. We conducted a secondary analysis of inflammatory and angiogenic analytes measured in plasma samples collected across pregnancy from 1462 Malawian women. Women with concentrations of the inflammatory markers sTNFR2, CHI3L1, and IL18BP in the highest quartile before 24 weeks gestation and women with anti-angiogenic factors sEndoglin and sFlt-1/PlGF ratio in the highest quartile at 28-33 weeks gestation, had an increased relative risk of preterm birth. Mediation analysis further supported a potential causal link between early inflammation, subsequent angiogenic dysregulation detrimnental to placental vascular development, and earlier gestational age at delivery. Interventions designed to reduce the burden of preterm birth may need to be implemented before 24 weeks of gestation.

Item Type: Article
Subjects: WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care
WQ Obstetrics > WQ 20 Research (General)
WQ Obstetrics > Pregnancy > WQ 200 General works
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 23 May 2023 11:01
Last Modified: 06 Jun 2023 12:21


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