Labor induces a maternal inflammatory response syndrome.
OBJECTIVE
We studied the effect of labor on maternal neutrophil phenotype.


METHODS
Neutrophil apoptosis with inflammatory cytokines and the expression of CD11b, CD34 and toll-like receptor 4 (TLR4) were assessed with flow cytometry in women at uncomplicated vaginal delivery (VD), and elective cesarean section (ElCS) without labor, emergency cesarean section with (EmCSL+) or without (EmCSL-) labor.


RESULTS
Spontaneous neutrophil apoptosis is delayed in maternal neutrophils after VD, EmCSL+ or EmCSL- versus ElCS. In all groups lipopolysaccharide delayed apoptosis and increased CD11b expression. Elevated TLR4 expression in ElCS was associated with lipopolysaccharide responsiveness. CD34 was diminished in VD, indicating increased cell maturity.


CONCLUSIONS
Normal labor primes the neutrophil and may enhance antibacterial function by inducing a mild maternal inflammatory response syndrome. Delayed neutrophil apoptosis may promote the neutrophilia seen in women after VD. We suggest that labor of any duration may be immunologically beneficial to the parturient.
Department of Surgery, Mater Misericordiae University Hospital, Conway Institute of Biomolecular and Biomedical Research, Dublin, Ireland.
Eleanor J
EJ
Molloy
Amanda J
AJ
O'neill
Julie J
JJ
Grantham
Margaret
M
Sheridan-Pereira
John M
JM
Fitzpatrick
David W
DW
Webb
R William
RW
Watson
D000954:Antigens, Surface / Q000378:metabolism; D017209:Apoptosis; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007743:Labor, Obstetric / Q000276:immunology*; D008562:Membrane Glycoproteins / Q000378:metabolism; D009504:Neutrophils / Q000502:physiology*; D010641:Phenotype; D011247:Pregnancy; D011956:Receptors, Cell Surface / Q000378:metabolism; D051197:Toll-Like Receptor 4; D051193:Toll-Like Receptors
D000954:Antigens, Surface; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D051193:Toll-Like Receptors