Department of Perinatology, Selcuk University Medical School, Konya, Turkey.
Department of Perinatology, Eskisehir City Hospital, Eskisehir, Turkey.
J Matern Fetal Neonatal Med. 2021 Oct;34(19):3192-3199. doi: 10.1080/14767058.2019.1679766. Epub 2019 Oct 24.
IL-33 is associated with invasion, proliferation, and metastasis of various cancers. The trophoblastic cells of placenta previa accreta (PPA) invade into the myometrium in a similar way to the invasion of cancers. We studied the role of IL-33 in PPA and also aimed to investigate its relation with adverse maternal outcome in this placental disorder.
A total of 87 pregnant patients were enrolled in this prospective case-control study [27 with PPA, 30 with placenta previa totalis (PPT; nonadherent placenta previa), and 30 controls]. IL-33 and IL-6 levels were studied in maternal serum at late preterm gestation weeks. Multiple logistic regression analyses analyzed the risk factors which are associated with PPA and adverse maternal outcomes. Adjusted odds ratios and 95% confidence intervals were also calculated. Enzyme-linked immunosorbent assay (ELISA) method was used to determine maternal serum IL-33 and IL-6 levels.
Serum IL-33 levels were significantly higher in PPA patients when compared with both nonadherent PPT and the control groups ( = .011, = .010). Serum IL-6 and neutrophil/lymphocyte ratio levels were significantly higher than the control group's ( = .045, = .028). IL-33 levels and history of previous cesarean section were found to be significantly associated with PPA (OR: 1.039, 95% CI: 1.004-1.075; = .030 and OR: 0.067, 95% CI: 0.014-0.309, = .001, respectively). Serum IL-33 levels were positively correlated with previous cesarean section history in PPA. Increased maternal serum IL-33 levels were found to be independently associated with a cesarean hysterectomy and massive transfusion in PPA patients (OR: 1.098, 95% CI: 0.998-1.207; = .049 and OR: 1.162 95% CI: 1.010-1.337; = .036).
Increased levels of maternal serum IL-33 and history of previous cesarean section were found to be significantly associated with PPA, and also increased maternal serum IL-33 levels were related to cesarean hysterectomy and massive blood transfusion in PPA. We suggest that IL-33 may have a role in abnormal placental invasion.
IL-33 与各种癌症的侵袭、增殖和转移有关。胎盘前置粘连（PPA）的滋养细胞以类似于癌症侵袭的方式侵入子宫肌层。我们研究了 IL-33 在 PPA 中的作用，并旨在探讨其与这种胎盘疾病中不良母婴结局的关系。
本前瞻性病例对照研究共纳入 87 例孕妇[27 例 PPA，30 例胎盘前置完全（PPT；不附着的胎盘前置），30 例对照组]。在晚期早产周检测母血清中 IL-33 和 IL-6 水平。多因素逻辑回归分析与 PPA 相关的危险因素及不良母婴结局。还计算了调整后的优势比和 95%置信区间。酶联免疫吸附试验（ELISA）法测定母血清 IL-33 和 IL-6 水平。
与非附着性 PPT 组和对照组相比，PPA 患者血清 IL-33 水平显著升高（ = .011， = .010）。血清 IL-6 和中性粒细胞/淋巴细胞比值明显高于对照组（ = .045， = .028）。IL-33 水平和既往剖宫产史与 PPA 显著相关（OR：1.039，95%CI：1.004-1.075； = .030 和 OR：0.067，95%CI：0.014-0.309， = .001）。PPA 患者中，血清 IL-33 水平与既往剖宫产史呈正相关。在 PPA 患者中，发现升高的母血清 IL-33 水平与剖宫产子宫切除术和大量输血独立相关（OR：1.098，95%CI：0.998-1.207； = .049 和 OR：1.162 95%CI：1.010-1.337； = .036）。
母血清 IL-33 水平升高和既往剖宫产史与 PPA 显著相关，母血清 IL-33 水平升高与 PPA 患者的剖宫产子宫切除术和大量输血有关。我们认为，IL-33 可能在异常胎盘侵袭中起作用。
