Viral Deregulation of Apoptotic Pathways and Its Correlation With Adverse Pregnancy Outcomes.

OBJECTIVE

Our objective was to correlate parvovirus-B19 and Epstein-Barr virus (EBV) infections with apoptotic biomarker levels in tissues from placentas from spontaneous abortions and cases of elective termination of pregnancy. We also explored if viral presence could cause spontaneous abortions by trying to associate the levels of pro-apoptotic markers with adverse pregnancy outcomes.

MATERIALS AND METHODS

We used 194 placental samples, of which 152 came from spontaneous abortions and were the study group and 42 controls came from cases of elective pregnancy termination. Hematoxylin and eosin (H&E) staining was performed to investigate morphological changes in the tissues, and then indirect immunohistochemistry to evaluate the expression of B19, EBV, M30, terminal deoxynucleotidyl transferase assay (TUNEL), and nuclear factor kappa B (NF-kB). Statistical analysis was performed using SPSS v. 19.0 (IBM).

RESULTS

Higher levels of apoptosis were observed in the spontaneous abortion group (p<0.001) with statistical significance and their presence was also correlated with statistical significance with viral infection (p<0.001). Also, viral infections were observed only in cases of spontaneous abortion. When simple and multivariate logistic regression was performed we confirmed that viral presence remained an independent prognostic factor for high expression of all apoptotic biomarkers with statistical significance (p<0.001).

CONCLUSIONS

Our results indicate that viral presence can lead to deregulation of apoptotic pathways within the maternal-fetal environment and thus work as a trigger event for spontaneous abortions.