THE SIGNIFICANCE OF INTERLEUKIN-22 AND HOMOCYSTEINE IN THE PROGNOSIS OF PREMATURE ANTEPARTUM RUPTURE OF MEMBRANES IN PREGNANT WOMEN.

BACKGROUND

Premature preterm rupture of membranes (PPROM) is a leading cause of preterm birth and neonatal complications. Identifying reliable biomarkers such as interleukin-22 (IL-22) and homocysteine (Hcy) is critical for early diagnosis, prognosis, and improved maternal-fetal outcomes.

OBJECTIVES

To systematically evaluate the prognostic significance of IL-22 and Hcy in predicting PPROM, preterm birth, and related maternal and neonatal outcomes in pregnant women.

METHODS

This systematic review (2015-2025) analyzed 10 studies on IL-22 and Hcy in PPROM. Literature was searched in PubMed, Cochrane Library, Europe PMC, ProQuest, and Google Scholar using PICO criteria. Data extraction was performed with an emphasis on reliability, and risk of bias was assessed with ROBINS-I.

RESULTS

Ten studies from diverse countries with varying designs and sample sizes were included. IL-22 was consistently elevated in women with PPROM and preterm birth (PTB). One included study reported a diagnostic cut-off value of 23.86 pg/mL with 72% sensitivity, while other studies supported an overall trend of increased IL-22 levels without establishing a uniform threshold. IL-22 was also associated with vaginal microecological imbalance, inflammatory responses, and immune modulation, although correlations with neonatal outcomes were inconsistent. Hcy showed a significant association with adverse pregnancy outcomes. Elevated levels predicted PPROM, PTB, miscarriage, and reduced fertility. Hyperhomocysteinemia was additionally linked to low birth weight, neonatal intensive care unit admission, and vitamin B12 deficiency. Overall, IL-22 and Hcy demonstrated considerable potential as biomarkers for predicting pregnancy complications, however, standardized thresholds require further validation through large-scale studies and meta-analytical approaches.

CONCLUSION

IL-22 and Hcy are promising biomarkers for predicting PPROM, PTB, and adverse pregnancy outcomes. Elevated IL-22 reflects immune modulation, while high Hcy correlates with fetal risk and neonatal complications. These findings support their potential application in early diagnosis and risk stratification.