title: Circulating TRAIL shows a significant post-partum decline associated to stressful conditions.
abstract: BACKGROUND
  Since circulating levels of TNF-related apoptosis inducing ligand (TRAIL) may be important in the physiopathology of pregnancy, we tested the hypothesis that TRAIL levels change at delivery in response to stressful conditions.
  
  
  RESULTS
  We conducted a longitudinal study in a cohort of 73 women examined at week 12, week 16, delivery and in the corresponding cord blood (CB). Serum TRAIL was assessed in relationship with maternal characteristics and to biochemical parameters. TRAIL did not vary between 12 (67.6±27.6 pg/ml, means±SD) and 16 (64.0±16.2 pg/ml) weeks' gestation, while displaying a significant decline after partum (49.3±26.4 pg/ml). Using a cut-off decline >20 pg/ml between week 12 and delivery, the subset of women with the higher decline of circulating TRAIL (41.7%) showed the following characteristics: i) nullipara, ii) higher age, iii) operational vaginal delivery or urgent CS, iv) did not receive analgesia during labor, v) induced labor. CB TRAIL was significantly higher (131.6±52 pg/ml) with respect to the corresponding maternal TRAIL, and the variables significantly associated with the first quartile of CB TRAIL (<90 pg/ml) were higher pre-pregnancy BMI, induction of labor and fetal distress. With respect to the biochemical parameters, maternal TRAIL at delivery showed an inverse correlation with C-reactive protein (CRP), total cortisol, glycemia and insulin at bivariate analysis, but only with CRP at multivariate analysis.
  
  
  CONCLUSIONS
  Stressful partum conditions and elevated CRP levels are associated with a decrease of circulating TRAIL.
authors.affiliation: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Zauli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monasta
authors.forename: Erika
authors.initials: E
authors.lastname: Rimondi
authors.forename: Liza
authors.initials: L
authors.lastname: Vecchi Brumatti
authors.forename: Oriano
authors.initials: O
authors.lastname: Radillo
authors.forename: Luca
authors.initials: L
authors.lastname: Ronfani
authors.forename: Marcella
authors.initials: M
authors.lastname: Montico
authors.forename: Giuseppina
authors.initials: G
authors.lastname: D'Ottavio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alberico
authors.forename: Paola
authors.initials: P
authors.lastname: Secchiero
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005316:Fetal Distress; D006801:Humans; D007743:Labor, Obstetric / Q000097:blood; D016015:Logistic Models; D015999:Multivariate Analysis; D049590:Postpartum Period / Q000097:blood* / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018709:Statistics, Nonparametric; D013312:Stress, Physiological; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*
chemical_list: D015415:Biomarkers; D053221:TNF-Related Apoptosis-Inducing Ligand; C505653:TNFSF10 protein, human; D002097:C-Reactive Protein