Dysregulation of maternal serum adiponectin in preterm labor

Shali Mazaki-Tovi, Roberto Romero, Edi Vaisbuch, Offer Erez, Pooja Mittal, Tinnakorn Chaiworapongsa, Sun Kwon Kim, Percy Pacora, Lami Yeo, Francesca Gotsch, Zhong Dong, Chia Ling Nhan-Chang, Cristiano Jodicke, Bo Hyun Yoon, Sonia S. Hassan, Juan Pedro Kusanovic

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Objective. Intra-amniotic and systemic infectioninflammation have been causally linked to preterm parturition and fetal injury. An emerging theme is that adipose tissue can orchestrate a metabolic response to insults, but also an inflammatory response via the production of adipocytokines, and that these two phenomenons are interrelated. Adiponectin, an insulin-sensitising, anti-inflammatory adipocytokine, circulates in multimeric complexes including low-molecular weight LMW trimers, medium-molecular weight MMW hexamers and high-molecular weight HMW isoforms. Each of these complexes can exert differential biological effects. The aim of this study was to determine whether spontaneous preterm labor PTL with intact membranes and intra-amniotic infectioninflammation IAI is associated with changes in maternal serum circulating adiponectin multimers. Study design. This cross-sectional study included patients in the following groups: 1 normal pregnant women n 158; 2 patients with an episode of preterm labor and intact membranes without IAI who delivered at term n 41; 3 preterm labor without IAI who delivered preterm n 27; and 4 preterm labor with IAI who delivered preterm n 36. Serum adiponectin multimers total, HMW, MMW and LMW concentrations were determined by ELISA. Non-parametric statistics were used for analyses. Results. 1 Preterm labor leading to preterm delivery or an episode of preterm labor that does not lead to preterm delivery was associated with a lower median maternal serum concentration of total and HMW adiponectin, a lower median HMWtotal adiponectin ratio and a higher median LMWtotal adiponectin ratio than normal pregnancy; 2 among patients with preterm labor, those with IAI had the lowest median concentration of total and HMW adiponectin, as well as the lowest median HMWtotal adiponectin ratio; 3 the changes in maternal adiponectin and adiponectin multimers remained significant after adjusting for confounding factors such as maternal age, BMI, gestational age at sampling and parity. Conclusion. 1 Preterm labor is characterised by a change in the profile of adiponectin multimers concentrations and their relative isoforms. These changes were observed in patients with an episode of preterm labor not leading to preterm delivery, in patients with intra-amniotic inflammation, or in those without evidence of intra-amniotic inflammation. 2 The changes in adiponectin multimer concentrations reported in preterm labor are different from those previously reported in spontaneous labor at term, suggesting that there is a fundamental difference between preterm labor and labor at term. 3 The findings reported herein provide the first evidence for the participation of adiponectin multimer in preterm parturition. We propose that adiponectins and adipokines in general provide a mechanism to organise the metabolic demands generated by the process of preterm parturition regardless of the nature of the insult intra-amniotic inflammation or not.

Original languageEnglish
Pages (from-to)887-904
Number of pages18
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number10
StatePublished - 9 Nov 2009
Externally publishedYes


  • Adipokines
  • Adiponectin
  • Chorioamnionitis
  • Energy expenditure
  • Energy requirements
  • High molecular weight
  • Inflammation
  • Intra-amniotic infection
  • Low molecular weight
  • Medium molecular weight
  • Metabolism
  • Pregnancy
  • Preterm birth
  • Preterm delivery
  • Preterm labor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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