Profile of matrix metalloproteinase activity, markers of collagen and elastin degradation and remodeling during pregnancy, delivery, and puerperium in pelvic organ prolapse 3 months after childbirth

Background: This study aims to assess the condition of pelvic organ prolapse related to changes in matrix metalloproteinase activity, elastin degradation and markers of collagen, and remodeling observed during pregnancy, childbirth, and the puerperal period 3 months postpartum. This study included 39 primigravida women who underwent vaginal delivery with a gestational age >36 weeks. This study conducted laboratory tests using blood and urine samples including procollagen type I N-propeptide (PINP), procollagen type-III N-propeptide (PIIINP), telopeptide carboxyl-terminal collagen type I (ICTP), matrix metalloproteinase-9 (MMP).-9), desmosin, and tropoelastin. The second and third blood samples will be examined 24-48 hours postpartum and 6 weeks postpartum. Method: The Mann-Whitney test and Repeated ANOVA were used to assess the median differences between biomarkers. Results: In the pelvic floor dysfunction and control groups, a significant relationship was found between serum MMP-9 levels 6 weeks postpartum (p=0.025). There were changes in biomarker levels of collagen and elastin during pregnancy, post-partum, and six weeks postpartum. The amount of degradation (MMP-9) seems to be correlated with the event of POP after childbirth. Conclusion: There were changes in the biomarker levels of collagen and elastin from pregnancy, post-partum, and six weeks postpartum. In addition, the difference was significant in MMP-9 level six weeks after postpartum in POP group compare to control.