The Predictors Of Obstetric And Perinatal Complications In Pregnant Women With Chronic Obstructive Pulmonary Disease

Svitlana Heryak¹ and Olena Oleksiak²*

¹Professor, Head of the Department of Obstetrics and Gynecology No2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
²PhD Student, Assistant Professor of the Department of Obstetrics and Gynecology No2, I. Horbachevsky Ternopil National Medical University, Ukraine

*Corresponding Author: Olena Oleksiak, PhD Student, Assistant Professor of the Department of Obstetrics and Gynecology No2, I. Horbachevsky Ternopil National Medical University, Ukraine.

Received: August 26, 2022; Published: October 28, 2022

Abstract

It is widely known that the systemic inflammatory process is a pathogenetic link in most diseases among which the leading place is occupied by COPD which is increasingly diagnosed in the female half of the population, in particular in pregnant women. As a result of the negative impact of systemic inflammation on the body of pregnant women, various obstetric and perinatal complications often develop.

The aim of our study was to establish the features of the relationship between systemic inflammation and the development of pregnancy complications in pregnant women with COPD.

Materials and Methods: After the clinical and instrumentally confirmed diagnosis of COPD, 77 pregnant women were examined. For the convenience, pregnant women were divided into 2 subgroups depending on the degree of bronchial obstruction: IA - 43 pregnant women with FEV1 ≥80%, IB - 34 pregnant women with FEV1 50-79%. The control group included 27 pregnant women without comorbidities. The main inflammatory mediators were identified and correlation with the degree of bronchial obstruction and the frequency of obstetric and perinatal complications.

The Results: We found that with an increase in the degree of bronchial obstruction, there is a more frequent diagnosis of such complications of pregnancy and childbirth as the threat of preterm birth in 9 (26.4%) pregnant women compared to 1 woman in the control (3.7%), preeclampsia was diagnosed in every 5 women (20.5%) compared to the control group where such pregnant women were absent, intrauterine growth retardation was detected in 8 women, which was 23.5% of the examined pregnant women of the IB subgroup, placental dysfunction was diagnosed in 3.4 times, preterm birth in 3.5 times, anemia in 3.1 times, premature rupture of membranes during childbirth in 4 times, fetal distress in 3 times more often compared to the control group. According to the results of correlation analysis, it was found that the development of these complications is based on chronic hypoxia and inflammation, which was manifested not only by an imbalance of interleukins in the form of increased levels of IL-1β, IL-6 and a decrease in IL-10 levels, but also an inverse correlation was between the level of FEV1 and the level of IL-1β (rI = -0.81, rII = -0.67, p < 0.01), FEV1 and IL-6 (rI = -0.88, rII = -0.78, p < 0.01), as well as a direct correlation between FEV1 and IL-10 (rI = 0.80, rII = 0.86, p < 0.01).

Conclusion: In the main group of pregnant women with mild and moderate degree of bronchial obstruction in whom the diagnosis of COPD was confirmed, there was a significant increase in the level of proinflammatory cytokines - IL-1β (rI = -0.81, rII = -0.67), IL-6 (rI = -0.88, rII = -0, 78), which was directly proportional to the degree of bronchial obstruction and inversely proportional to the level of anti-inflammatory IL-10 (rI = 0.80, rII = 0.86), which may be a characteristic feature of the early development of obstetric and perinatal complications.
We found a relationship between the increased degree of bronchial obstruction and a higher incidence of pregnancy complications such as the threat of preterm birth in 26.4% of pregnant women with IB subgroup compared to 1 woman in the control group (3.7%), preeclampsia was diagnosed in every 5 women (20.5%) compared to the control group where such pregnant women were absent, intrauterine growth retardation was detected in 8 women, which was 23.5% of the examined pregnant women of the IB subgroup, placental dysfunction was diagnosed in 3.4 times, preterm birth in 3.5 times, anemia in 3.1 times, premature rupture of membranes during childbirth in 4 times, fetal distress in 3 times more often compared to the control group.

Keywords: Pregnancy; Chronic Obstructive Pulmonary Disease; Obstetric Complications; Bronchial Obstruction; Cytokines

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Citation

Citation: Svitlana Heryak and Olena Oleksiak. “The Predictors Of Obstetric And Perinatal Complications In Pregnant Women With Chronic Obstructive Pulmonary Disease". Acta Scientific Women's Health 4.11 (2022): 27-33.

Copyright

Copyright: © 2022 Svitlana Heryak and Olena Oleksiak. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.