Biochemical and immunological predictors of labor induction in women with preterm premature rupture of membranes

The objective: to investigate the levels of antibodies against chaperonins HSP60 and GroEL as potential markers of the effectiveness of labor induction in women with preterm premature rupture of membranes (PPROM).Materials and methods.A prospective cohort study was conducted including 79 pregnant women with PPROM who underwent labor induction. Based on the success of induction, the women were divided into two groups: 46 (58%) experienced successful induction, while 33 (42%) required cesarean section after an unsuccessful induction attempt. Exclusion criteria were multiple pregnancy, delivery before 37 weeks of gestation, stillbirth, and the presence of extragenital pathology. The study was carried out in the absence of clinical signs of infection. All biochemical parameters were obtained after serum analysis, performed immediately following the diagnosis of PPROM.Results.Antibody levels to HSP60 were 149.27 ± 53.99 and 196.41 ± 55.58, and to GroEL 136.82 ± 32.3 and 143.87 ± 30.04 ng/mL in the groups with unsuccessful and successful labor induction, respectively. Statistical analysis revealed a significant (p < 0.05) association between the level of antibodies to HSP60 and the success of labor induction. Correlation analysis demonstrated a weak positive relationship between immunoglobulin concentrations to chaperonins HSP60 and GroEL (r = 0.253; p < 0.05), which is likely attributable to their homology. In the constructed model, the primary factor associated with successful induction was the level of antibodies to HSP60. The antibody level to the chaperonin showed a positive correlation with the likelihood of successful induction. The following logistic regression formula was obtained: logit(P)= –1,69+0,012 × (антитіла до HSP60). The calculated area under the curve (AUC) was 0.705 (95% CI = 0.579–0.832), with a model sensitivity of 0.87 and specificity of 0.58. The optimal diagnostic threshold was determined to be 0.45 according to the Youden index.Conclusions.The serum level of immunoglobulins to HSP60 is a promising biochemical marker for the success of labor induction in cases of PPROM. The statistically significant association between antibody concentration to HSP60 and induction success suggests a potential involvement of this protein in the mechanisms of sterile inflammation and cervical maturation.