Impact of Prematurity on the Buccal Epithelial Cells of the Neonates via Wnt/Beta-Catenin Signaling Pathway and Apoptosis

Abstract

Objective Understanding the reflections of prematurity is necessary for the management of neonatal complications. We focused on the impact of prematurity and related maternal risk factors/obstetric complications on buccal cells of the neonates via evaluation of the Wnt/beta-catenin signaling pathway and apoptosis. Study Design This study consisted of early preterm neonates (EPN) (<= 34th gestational week [gw]) (n = 36), late preterm neonates (LPN) (34th-< 37th gw) (n = 46), and term neonates (control) (>= 37th gw) (n = 56). Cohort was also subclassified according to the presence of maternal risk factors, obstetric complications, and neonatal complications. Wnt/beta-catenin signaling and caspase-3 activation pathways were studied immunocytochemically. Results Wnt/beta-catenin signaling positivity was statistically more frequent at buccal smears of the EPN and LPN groups compared with controls (p<0.001). The cutoff for gestational age at delivery in receiver operating characteristic curve with the best balance of sensitivity (67.4%) and specificity (67.3%) was 35.8th gw for determining the reduction of Wnt/beta-catenin signaling positivity (p< 0.001). The study demonstrated that obstetric complications significantly affected the activity of signaling, while maternal risk factors do not have any effect on Wnt/beta-catenin signaling pathway (p = 0.003 and p = 0.828, respectively). This study also demonstrated a significant relationship between Wnt/beta-catenin signaling pathway and the presence of neonatal complications (p = 0.015). Conclusion Dynamic characteristics of buccal cells are influenced by prematurity and related obstetric and neonatal problems. Buccal smear is a good tool to investigate the impact of prematurity and obstetric problems on perinatal outcome.