Associations of HMGB1, sTNFR-1 and NRL with the infectious premature delivery in pregnant women undergoing cervical cerclage

Abstract

ObjectiveTo investigate the associations of changes in the high mobility group box 1 (HMGB1), soluble tumor necrosis factor receptor 1 (sTNFR-1) and peripheral blood neutrophil-to-lymphocyte ratio (NLR) with the infectious premature delivery in pregnant women undergoing cervical cerclage. MethodsSixty-seven pregnant women with premature delivery after cervical cerclage, who were treated at the Maternal and Child Health Hospital affiliated to Nantong University from January 2022 to October 2023, were enrolled, including 43 with infectious premature delivery (infectious group) and 24 with non-infectious premature delivery (non-infectious group). The pre-delivery serum levels of HMGB1, sTNFR-1 and the peripheral blood level of NRL were compared between the two groups. Further, the clinical value of these three indicators in predicting infectious premature delivery among pregnant women undergoing cervical cerclage was assessed by the receiver operating characteristic (ROC) curve analysis. Results The infectious group exhibited significantly higher serum levels of HMGB1 (6.85 ± 2.08 mg/L), sTNFR-1 (4.77 ± 1.13 pg/ml) and peripheral blood level of NRL (6.51 ± 2.51) compared to those in the non-infectious group (4.01 ± 1.05 mg/L, 3.75 ± 0.66 pg/ml and 3.60 ± 1.48), showing significant differences (t = 7.44, 4.64 and 5.92, P < 0.05). Logistic regression analysis revealed that the HMGB1 and NRL were independent influencing factors for premature delivery (P < 0.05). According to the ROC curve analysis results, the changes in HMGB1, sTNFR-1 and NRL levels could somewhat reflect the risk of infectious premature delivery among pregnant women undergoing cervical cerclage. The AUC, sensitivity and specificity of combined detection were all markedly higher than those of independent detection. ConclusionHMGB1, sTNFR-1 and NRL levels are the risk factors for third-trimester premature delivery among pregnant women undergoing cervical cerclage. Timely combined detection of serum HMGB1, sTNFR-1 and peripheral blood NRL at the third trimester can improve the clinical diagnostic rate, which enables early prevention to help lower the risk of premature delivery.