Journal of International Obstetrics and Gynecology ›› 2025, Vol. 52 ›› Issue (2): 121-126.doi: 10.12280/gjfckx.20241001

• Obstetric Physiology & Obstetric Disease: Review •     Next Articles

Progress on the Relationship between Apoptosis and Adverse Pregnancy Outcomes

MA Ling, LI Ya-xi, ZHAO Min, WANG Jing(), LI Hong-li   

  1. The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China (MA Ling, LI Ya-xi, ZHAO Min); The First Hospital of Lanzhou University, Lanzhou 730000, China (WANG Jing, LI Hong-li)
  • Received:2024-11-06 Published:2025-04-15 Online:2025-04-22
  • Contact: WANG Jing E-mail:wjdyx2008@126.com

Abstract:

Apoptosis is a programmed cell death that plays a crucial role in the physiological and pathological processes of pregnancy. Abnormal apoptosis, especially excessive apoptosis of trophoblast cells in the placenta, may lead to trophoblast dysfunction, abnormal vascular remodeling, increased oxidative stress, and immune imbalance, thereby cause adverse pregnancy outcomes such as recurrent spontaneous abortion (RSA), pre-eclampsia (PE), gestational diabetes mellitus (GDM), and preterm birth. The regulation of apoptosis is vital for pregnancy. In the RSA, p53-mediated apoptosis and abnormal expression of miR-184 and miR-27a disrupt the balance between trophoblast proliferation and apoptosis. In PE, the miR-4531/CX3CL1 signaling pathway is involved in the pathogenesis of PE by regulating vascular endothelial injury. In GDM, ghrelin shows potential therapeutic value by downregulating the endoplasmic reticulum stress signaling pathway. In preterm birth, endoplasmic reticulum stress induces apoptosis of alveolar epithelial cells via the inositol-requiring enzyme 1α(IRE1α)/c-Jun N-terminal protein kinase(JNK) pathway. Future research needs to further explore its mechanisms and therapeutic targets to provide new ideas for the prevention and treatment of adverse pregnancy outcomes.

Key words: Apoptosis, Pregnancy outcome, Abortion, habitual, Pre-eclampsia, Diabetes, gestational, Premature birth