Pregnancy and childbirth are physiological states characterized by sudden hormonal and immunologically described changes. The current study aimed to investigate the influence of maternal variables (age, previous abortion, placental position, and fetal position) on some physiological biomarkers, such as oxytocin (OT), prolactin (PRL), cortisol, and insulin growth factor 2 (IGF -2) and some immune biomarkers such as programmed cell death protein 1 (PD-1), programmed cell death ligand 1 (PD-L1) and interleukin 6 (IL-6) in Iraqi women undergoing caesarean section (CS). Blood samples were collected from 48 pregnant women in the age range (16-43 years) and serum was obtained to determine the levels of the above biomarkers. The effect of maternal age on physiological biomarkers showed that OT levels increased significantly with maternal age (P≤0.001), whereas PRL, cortisol, and IGF-2 levels were not (P˃0.05), showing differences between age categories. The effect of maternal age on immune biomarkers showed that PD-1 levels decreased significantly (P<0.05) and PD-L1 and PD-1/PD-L1 levels were highly significant (P≤ 0.001), however, IL-6 level shows a non-significant (P˃0.05) difference between age categories. Regarding the effect of previous abortion, statistical analysis showed that cortisol levels were significantly (P<0.05) lower in women with previous abortion compared to women without previous abortion, while OT, PRL, and IGF-2 levels were not significantly different (P ˃ 0.05) difference between the two groups. PD-1 and PD-L1 levels showed a significant (P<0.05) decrease in women with previous abortion compared with women without abortion, while IL-6 mirror images did not differ significantly (P˃0.05) between the two groups. The effect of placenta position showed that when the placenta was in the anterior position, the PRL level was significantly increased (P≤0.001), IGF-2 level was significantly decreased (P<0.05), while the OT and cortisol levels were significantly higher (P≤0.001) compared with the posterior position There was no significant difference between the two groups (P˃0.05). When the placenta was located in the anterior compared with the posterior, the level of PD-L1 was significantly (P<0.05) lower, while the levels of PD-1 and PD -1/PD- were not significantly different (P˃0.05). L1 and IL-6 between the two groups. According to fetal position, statistical analysis showed no significant difference in all physiological and immune biomarkers when the fetus was in cephalic or breech position (P˃0.05). It can be concluded that the more maternal variables which affect on the physiological and immunological biomarkers of the women undergoing caesarean section are maternal age and a previous abortion.
