lactoferrin and Fetal-Membranes--Premature-Rupture

The aim of this systematic review was to report the role of lactoferrin supplementation for the prevention of preterm birth (PTB) in women at risk.. PubMed and Embase databases were searched. Inclusion criteria were studies exploring maternal and perinatal outcomes in women at high-risk for preterm birth receiving compared to those not receiving lactoferrin during pregnancy. The primary outcome was preterm PTB<37 weeks; the secondary outcomes were gestational age at birth, PTB<34 and 28 weeks, preterm premature rupture of the membranes (PPROM), chorioamnionitis and admission to Neonatal Intensive Care Unit. Random effect meta-analyses were used to analyze the data.. Six studies (333 pregnancies) were included. Overall, women taking lactoferrin had a lower risk of PTB<37 weeks of gestation with an OR of 0.43 (95% CI: 0.2-0.9). Likewise, gestational age at delivery was higher in women-taking compared to those not-taking lactoferrin (MD=0.46 weeks, SD=0.17, P=0.006). The other included studies explored the role of lactoferrin in affecting the inflammatory profile in the amniotic fluid of women undergoing invasive test, without reporting its actual role in preventing PTB.. Prophylactic administration of lactoferrin can reduce the risk of PTB in women at risk. Further large and adequately powered randomized trial are needed in order to elucidate the actual role of lactoferrin in reducing the risk of preterm birth and in affecting perinatal outcomes in women at risk.

Topics: Chorioamnionitis; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Lactoferrin; Pregnancy; Premature Birth

To evaluate use of vaginal lactoferrin in prevention of preterm birth (PTB) in women with first trimester bacterial vaginosis and prior spontaneous PTB.. This is a retrospective cohort study of all consecutive singleton gestations with prior PTB, and first trimester diagnosis of bacterial vaginosis. Women who were found to have bacterial vaginosis were recommended lactoferrin 300 mg vaginal tablets daily for 21 days. The primary outcome was the incidence of PTB at less than 37 weeks of gestations. Outcomes were compared in women who received daily lactoferrin with those who did not.. During the study period, 847 pregnant women with prior spontaneous PTB were screened for bacterial vaginosis. Of them, 193 were found to have bacterial vaginosis in the first trimester, with an overall incidence of 22.8%. Out of the 193 women, 125 met the inclusion criteria for the study and were analyzed. Sixty of the included women received vaginal lactoferrin, while 65 did not. Women who received supplementation with lactoferrin had a significantly lower rate of PTB < 37 weeks (25.0 versus 44.6%;. Based on this small single-center retrospective study, supplementation with vaginal lactoferrin in women with first trimester bacterial vaginosis may be an option to reduce the risk of preterm delivery.

Topics: Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Lactoferrin; Pregnancy; Premature Birth; Retrospective Studies; Vaginosis, Bacterial

Lactoferrin (LF) is one of the prebiotics present in the human body. A 38-year-old multiparous woman with poor obstetrical histories, three consecutive preterm premature rupture of membrane at the 19th, 23rd and 25th week of pregnancy, was referred to our hospital. She was diagnosed as having refractory vaginitis. Although estriol vaginal tablets were used for 4 months, the vaginitis was not cured. We administrated vaginal tablets and oral agents of prebiotic LF, resulting in a Lactobacillus predominant vaginal flora. When she was pregnant, she continued to use the LF, and the Lactobacillus in the vaginal flora was continuously observed during pregnancy. An elective cesarean section was performed at the 38th week of pregnancy. When the administration of LF was discontinued after the delivery, Lactobacillus in the vaginal flora was disappeared.

Topics: Adult; Female; Fetal Membranes, Premature Rupture; Humans; Lactobacillus; Lactoferrin; Prebiotics; Pregnancy; Pregnancy Complications, Infectious; Premature Birth; Streptococcal Infections; Streptococcus agalactiae; Vagina; Vaginosis, Bacterial

Lactoferrin, an iron-binding glycoprotein found in cervical mucus and amniotic fluid, plays a defensive role against mucosal infections. This study examined the effect of recombinant human lactoferrin on preterm delivery in a rabbit model.. Anesthetized rabbits were randomly assigned to receive either inoculation with Escherichia coli or saline solution and to receive treatment with or without recombinant human lactoferrin inserted into the cervix 2 hours before bacterial inoculation (condition A: saline + saline; condition B: E coli + saline; condition C: E coli + recombinant human lactoferrin). E coli , saline solution, and recombinant human lactoferrin were inserted into the cervix using a hysteroscope and a sterile polyethylene cannula. Fetus survival rate and days to delivery after inoculation were monitored and tumor necrosis factor-alpha concentrations were measured in maternal serum and amniotic fluid.. Fetus survival for conditions A, B, and C were 95.7%, 0%, and 32.6%, respectively, whereas pregnancy continuation was 7.00 +/- 0 days, 3.25 +/- 0.43 days, and 4.85 +/- 1.77 days, respectively.. Cervical recombinant human lactoferrin administration increased fetal survival and extended pregnancy. Lactoferrin has an anti-inflammatory action as well as an antibacterial action, suggesting that recombinant human lactoferrin has the potential to prevent preterm delivery originating from cervical infection in the clinical setting.

Topics: Animals; Disease Models, Animal; Escherichia coli Infections; Female; Fetal Death; Fetal Membranes, Premature Rupture; Humans; Immunohistochemistry; Lactoferrin; Obstetric Labor, Premature; Placenta; Pregnancy; Pregnancy, Animal; Primary Prevention; Rabbits; Random Allocation; Recombinant Proteins; Reference Values; Sensitivity and Specificity; Tumor Necrosis Factor-alpha

Our purpose was to determine whether maternal plasma levels of neutrophil granule products are elevated in patients with chorioamnionitis after preterm premature rupture of membranes (PROM).. Fifty-two patients between 24 and 34 weeks' gestation with preterm PROM were included. Plasma samples for defensins and lactoferrin were collected throughout latency. Fifty-two control subjects between 26 and 30 weeks' gestation were recruited for baseline levels.. Mean control defensin levels were compared with mean defensin levels on admission (668 ng/mL vs 5665 ng/mL, P<.01). Mean defensin levels on admission in patients without chorioamnionitis were compared with those of patients in whom histologic chorioamnionitis developed (520 ng/mL vs 9163 ng/mL, P<.01). The same relationships were not demonstrated for lactoferrin. With use a defensin value of 1500 ng/mL on admission, the sensitivity is 76% and specificity is 94% in predicting histologic chorioamnionitis.. Maternal plasma levels of defensins are markers of histologic chorioamnionitis in patients after preterm PROM.

Topics: Anti-Infective Agents; Chorioamnionitis; Cytoplasmic Granules; Defensins; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Lactoferrin; Neutrophils; Placenta; Pregnancy; Sensitivity and Specificity; Time Factors

Lactoferrin is an iron-binding protein with antimicrobial properties. This study was undertaken to determine whether amniotic fluid concentrations of this protein change with gestational age, infection, labor, and rupture of membranes.. This cross-sectional study included women who underwent transabdominal amniocentesis (n = 268) in the following groups: (1) mid trimester of pregnancy; (2) preterm labor who delivered at term, preterm labor who delivered preterm with intra-amniotic infection, and preterm labor who delivered preterm without intra-amniotic infection; (3) preterm premature rupture of membranes in the presence or absence of intra-amniotic infection; (4) term with intact membranes not in labor, in labor, and in labor with intra-amniotic infection; and (5) premature rupture of membranes at term not in labor. In addition, lactoferrin concentrations were determined in maternal plasma and cord blood of patients at term not in labor. Lactoferrin concentration was measured with an immunoassay.. (1) Lactoferrin was detectable in 85.4% (229/268) of amniotic fluid samples, not detectable in all fluid obtained in the mid trimester, and detectable in all maternal and cord plasma samples. (2) The concentration of lactoferrin increased with advancing gestational age (r = 0.68; P <.0001). (3) Intra-amniotic infection was associated with significant increases in amniotic fluid lactoferrin concentrations in patients with preterm labor (no intra-amniotic infection median, 1641.2 ng/mL; range, <1.24-35,090.0 ng/mL; vs intra-amniotic infection median, 3833.6 ng/mL; range, 746.0-47,020.0 ng/mL; P <.001), term labor (no intra-amniotic infection median, 2085.8 ng/mL; range, 425.0-23,230.0 ng/mL; vs intra-amniotic infection median, 5627.0 ng/mL; range, <1.24-19,220.0 ng/mL; P <. 001), and preterm premature rupture of membranes (no intra-amniotic infection median, 2190 ng/mL; range, <1.24-7456.1 ng/mL; vs intra-amniotic infection median, 3449.3 ng/mL; range, <1.24-83,600. 0; P <.01). (4) Spontaneous labor at term but not preterm was associated with a significant decrease in amniotic fluid lactoferrin concentration (P <.05). (5) Spontaneous term parturition was associated with a significant increase in umbilical cord plasma lactoferrin concentration (P <.005).. (1) Intra-amniotic infection was consistently associated with dramatically increased concentrations of lactoferrin in amniotic fluid. (2) Term parturition was associated with a significant increase in lactoferrin concentration in the fetal compartment (umbilical cord blood) and a decrease in the amniotic compartment. We propose that lactoferrin is part of the repertoire of host defense mechanisms against intra-amniotic infection.

Topics: Cross-Sectional Studies; Female; Fetal Blood; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infections; Labor, Obstetric; Lactoferrin; Pregnancy; Ureaplasma Infections; Ureaplasma urealyticum; Uterine Diseases

Eleven of 15 serum lactoferrin (S-LF) values and all 16 C-reactive protein (CRP) values were significantly elevated in cases of premature rupture of the amniotic membranes (PROM). There was no correlation between values of C-reactive protein and lactoferrin in either mothers or their newborn. The difference in C-reactive protein between mothers and their newborn was significant, but this was not the case with serum lactoferrin. This suggest that there is no transplacental transfer of C-reactive protein, even in preterm rupture of the membranes, and this is probably also the case with lactoferrin.

Topics: C-Reactive Protein; Female; Fetal Blood; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Lactoferrin; Lactoglobulins; Maternal-Fetal Exchange; Pregnancy; Pregnancy-Specific beta 1-Glycoproteins