Bovine lactoferrin in preterm labor with sterile inflammation

Background
Preterm delivery (PTD) that occurs before the 37th week of gestation complicates 10% of all pregnancies. Iron deficiency, iron-deficiency anemia, and inflammatory processes either related to infection or sterile inflammatory response represent risk factors for PTD (Genc and Ford, 2010). Bovine lactoferrin (BLF), an emerging important regulator of iron and inflammatory homeostasis, can represent a new therapeutic approach for PTD, with significant improvement of maternal serum interleukin 6 (IL-6) after oral administration.


Aim
The goal of the study was to evaluate the role of BLF in preventing PTD associated with sterile inflammation between the gestational age of 28 and 34 weeks.


Patients and methods
The study was carried out at Al Zahra University Hospital at the Department of Obstetrics and Gynecology, including 50 patients, with single pregnancy, no previous preterm birth, gestational age between 28 and 34 weeks, rhythmic uterine contraction (three to five contraction in 10 min; every one last from 40 to 60 s), cervical dilation of 2–4 cm and cervical effacement of ∼50–80% by local pelvic examination, and cervical length 2–3 cm and/or funneling by ultrasound. On admission, all patients were given 100 mg BLF and subjected to withdrawal of 5-ml blood, and samples were sent to Clinical Pathology Department to detect IL-6 before and after BLF intake.


Results
Oral BLF administration blocked further shortening of cervical length and prolonged pregnancy. This prospective study provides strong evidence for a role of BLF in PTD treatment, thus extending the therapeutic potential of this multifunctional protein.


Conclusion
Determination of maternal serum IL-6 may be useful for management of patients with preterm labor, and BLF can represent a new therapeutic approach of PTD.