Role of Apoptosis Inducing Factor (AIF) as Risk Factors of Premature Rupture of Membranes

Abstract

Premature rupture of membrane (PROM) is an obstetric problem related to the prevalence, prematurity, morbidity and mortality of perinatal. The etiology of PROM is multifactorial and the mechanism remains unclear. The weakening of amniotic membrane is suspected due to various biochemistry process that causing remodeling and apoptosis, and the stretch of the amniotic membrane. Apoptosis plays an integrated role in the pathogenesis of PROM. The mechanism of apoptosis is through caspase-dependent and caspase-independent pathway. Apoptosis protein such as Apoptosis Inducing Factor (AIF) as caspase independent are hypothesized to be involved as the risk factor of PROM. To determine the role of AIF as caspase independent in the mechanism of patogenesis of premature rupture of membranes. A case-control study with PROM as a case, and non-PROM as a control at 20-42 weeks gestation age. Amniotic tissue was taken after delivery of the placenta. Immunohistochemical examination of AIF was done at Integrated Lab. Biomedic Medical Faculty of Udayana University in Bali. The study was conducted on 37 cases of PROM and 46 cases non PROM. There was no characteristic difference between the case and control groups (p>0.05). The expression of positive AIF is a risk factor of PROM of 5.10 times (OR = 5.10; CI 95% = 1.86 to 13.96 ; p = 0.001). AIF expression was more in the group of PROM. AIF expression is a risk factor for premature rupture of membranes.