THE CORRELATION BETWEEN THE VITAMIN D RECEPTOR AND TIMP-1 IN THE PLACENTA ACCRETA SPECTRUM

Problem statement:The incidence of placenta accreta in Indonesia has reached 2%. Placenta accreta occurs due to the invasion of abnormal trophoblasts to the myometrium. 1,25-(OH)2D is an active compound of vitamin D and acts as the main ligand of VDR. It also increases the expression of TIMP-1 in trophoblast invasion. This study aimed to determine the correlation of VDR expression with TIMP-1 on the placenta accreta.

Method: This is a cross-sectional study with 80 samples for twoexpressions, consisting of 40 placentas accreta and 40 normal placentas. Immunohistochemistry assays were used to assess the expression of VDR and TIMP-1. Data analysis was conducted with different tests and correlation tests.

Results: There was a significant difference between VDR expression on the placenta accreta and normal placenta with a P value of < 0.05. Patients with a lower VDR H-Score were 4.5 times more likely to experience the placenta accreta spectrumdisorder than those with a higher VDR H-Score. In addition, there was a significant difference in TIMP-1 expression betweenplacenta accreta and normal placenta with a P value of < 0.05. Patients with a lower TIMP-1 H-Score were 3.115 times more likely to experience placenta accreta spectrum disorder thanthose with a higher H-Score. The results of the Spearman correlation test also showed a correlation between VDR and TIMP-1 on the placental spectrum with a correlation coefficient of 0.89.

Conclusion: The expressions of VDR and TIMP-1 in placenta accreta spectrum patients were lower than in normal placenta, and there was a correlation between VDR and TIMP-1 in the placenta accreta spectrum disorder.