Association between serum tumor necrosis factor-alpha and corticotropin-releasing hormone levels in women with preterm labor.

Aim: To evaluate the association of serum corticotropin-releasing hormone (CRH) and tumor necrosis factor-alpha (TNF-alpha) in preterm labor.

Methods: Forty-nine primigravidas with a singleton viable pregnancy between 28 and 34 weeks of gestation were studied. They were divided into two groups. Group A consisted of 30 pregnant women (mean gestational age: 30.6 week) who presented with preterm labor and group B consisted of 19 pregnant women (mean gestational age: 29.8 week) with normal pregnancies.

Results: Women of group A had significantly higher serum CRH levels compared to those of group B (P < 0.01). Similarly, serum TNF-alpha levels were significantly higher in women of group A when compared to women of group B (7.8 +/- 3.72 pg/mL and 5.1 +/- 3.72 pg/mL, respectively). Furthermore, a positive correlation was found between serum CRH and TNF-alpha levels in both groups, which was stronger in women of group A.

Conclusions: Our findings suggest that the increased levels of TNF-alpha and CRH found in pregnant women presenting with preterm labor may be involved in the pathophysiological mechanism of the latter. Furthermore, a positive interaction may exist between TNF-alpha and placental CRH, which may lead to enhanced production of the second and, therefore, facilitate the onset of labor.