Open AccessProstaglandins in biofluids in pregnancy and labour: A systematic review
Author(s) -
Eilidh M Wood,
Kylie K. Hornaday,
Donna M. Slater
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0260115
Subject(s) - pregnancy , prostaglandin , amniotic fluid , preterm labour , metabolite , medicine , urine , obstetrics , physiology , endocrinology , bioinformatics , gestation , fetus , biology , genetics
Prostaglandins are thought to be important mediators in the initiation of human labour, however the evidence supporting this is not entirely clear. Determining how, and which, prostaglandins change during pregnancy and labour may provide insight into mechanisms governing labour initiation and the potential to predict timing of labour onset. The current study systematically searched the existing scientific literature to determine how biofluid levels of prostaglandins change throughout pregnancy before and during labour, and whether prostaglandins and/or their metabolites may be useful for prediction of labour. The databases EMBASE and MEDLINE were searched for English-language articles on prostaglandins measured in plasma, serum, amniotic fluid, or urine during pregnancy and/or spontaneous labour. Studies were assessed for quality and risk of bias and a qualitative summary of included studies was generated. Our review identified 83 studies published between 1968–2021 that met the inclusion criteria. As measured in amniotic fluid, levels of PGE 2 , along with PGF 2α and its metabolite 13,14-dihydro-15-keto-PGF 2α were reported higher in labour compared to non-labour. In blood, only 13,14-dihydro-15-keto-PGF 2α was reported higher in labour. Additionally, PGF 2α , PGF 1α , and PGE 2 were reported to increase in amniotic fluid as pregnancy progressed, though this pattern was not consistent in plasma. Overall, the evidence supporting changes in prostaglandin levels in these biofluids remains unclear. An important limitation is the lack of data on the complexity of the prostaglandin pathway outside of the PGE and PGF families. Future studies using new methodologies capable of co-assessing multiple prostaglandins and metabolites, in large, well-defined populations, will help provide more insight as to the identification of exactly which prostaglandins and/or metabolites consistently change with labour. Revisiting and revising our understanding of the prostaglandins may provide better targets for clinical monitoring of pregnancies. This study was supported by the Canadian Institutes of Health Research.