scholarly journals Biochemical Markers As Predictor Of Preterm Labor- Their Clinical Relevance And The Current Status

2020 ◽  
Author(s):  
Suneeta Singh ◽  
Madhusudhan Dey ◽  
Sanjay Singh ◽  
Shibu Sasidharan
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Preterm Labor ◽  
Biochemical Markers ◽  
Preterm Births ◽  
Current Status ◽  
Perinatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Asymptomatic Women

Preterm birth is associated with significant perinatal morbidity and mortality. Spontaneous preterm birth accounts for upto 75% of all preterm births. A number of maternal and fetal characteristics have been associated with preterm birth. With better understanding of the pathophysiology of preterm birth, various biochemical markers have been studied extensively to predict the preterm birth efficiently so as to intervene appropriately and timely in the cases that would benefit from treatment. This paper provides a summary of the current literature on the use of biochemical markers in predicting spontaneous preterm birth in symptomatic and high risk-asymptomatic women. Evidence from the literature suggests cervico vaginal fetal fibronectin,interleukin-6, phosphorylated Insulin-like growth factor binding protein-1(phIGFBP1), placental alpha macroglobulin-1 (PAMG-1) and serum

scholarly journals Biochemical Markers of Spontaneous Preterm Birth in Asymptomatic Women

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ronna L. Chan
Keyword(s):  
Preterm Birth ◽  
Biochemical Markers ◽  
Preterm Births ◽  
Future Research ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Potential Risk Factors ◽  
Underlying Mechanisms ◽  
Development And Validation ◽  
Asymptomatic Women

Preterm birth is a delivery that occurs at less than 37 completed weeks of gestation and it is associated with perinatal morbidity and mortality. Spontaneous preterm birth accounts for up to 75% of all preterm births. A number of maternal or fetal characteristics have been associated with preterm birth, but the use of individual or group biochemical markers have advanced some of the understanding on the mechanisms leading to spontaneous preterm birth. This paper provides a summary on the current literature on the use of biochemical markers in predicting spontaneous preterm birth in asymptomatic women. Evidence from the literature suggests fetal fibronectin, cervical interleukin-6, andα-fetoprotein as promising biochemical markers in predicting spontaneous preterm birth in asymptomatic women. The role of gene-gene and gene-environment interactions, as well as epigenetics, has the potential to further elucidate and improve understanding of the underlying mechanisms or pathways of spontaneous preterm birth. Refinement in study design and methodology is needed in future research for the development and validation of individual or group biochemical marker(s) for use independently or in conjunction with other potential risk factors such as genetic variants and environmental and behavioral factors in predicting spontaneous preterm birth across diverse populations.

The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: fifteen-year outcomes from a leading maternal centre

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Wallace Jin ◽  
Kelly Hughes ◽  
Shirlene Sim ◽  
Scott Shemer ◽  
Penelope Sheehan
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Serum Alkaline Phosphatase ◽  
Conclusive Evidence ◽  
Primary Data ◽  
Spontaneous Preterm Birth ◽  
Short Cervix ◽  
Fetal Fibronectin ◽  
Retrospective Audit ◽  
Singleton Pregnancies

Abstract Objectives Preterm birth clinics provide dedicated obstetric care to women at high risk of spontaneous preterm birth (SPTB). There remains a lack of conclusive evidence to support the overall utility of such clinics, attributable to a paucity and heterogeneity of primary data. This study audits Australia’s largest and oldest dedicated preterm birth clinic with the aim to add primary data to the area and offer opportunities for similar clinics to align practice. Methods A retrospective audit of referrals to the Preterm Labour Clinic at the Royal Women’s Hospital, Melbourne, Australia, between 2004 and 2018 was conducted. 1,405 singleton pregnancies met inclusion criteria. The clinic’s key outcomes, demographics, predictive tests and interventions were analysed. The primary outcomes were SPTB before 37, 34 and 30 weeks’ gestation. Results The overall incidence of SPTB in the clinic was 21.2% (n=294). Linear regression showed reductions in the adjusted rates of overall SPTB and pre-viable SPTB (delivery <24 weeks) from 2014 (108%; 8%) to 2018 (65%; 2% respectively). Neonatal morbidity and post-delivery intensive care admission concurrently declined (p=0.02; 0.006 respectively). Rates of short cervix (cervical length <25 mm) increased over time (2018: 30.9%) with greater uptake of vaginal progesterone for treatment. Fetal fibronectin, mid-trimester short cervix, and serum alkaline phosphatase were associated with SPTB on logistic regression. Conclusions Dedicated preterm birth clinics can reduce rates of SPTB, particularly deliveries before 24 weeks’ gestation, and improve short-term neonatal outcomes in pregnant women at risk of preterm birth.

Correlation of cervical length, fetal fibronectin, phIGFBP-1, and cytokines in spontaneous preterm birth up to 14 days from sampling

2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Marija Hadži-Lega ◽  
Ana Daneva Markova ◽  
Milan Stefanovic ◽  
Mile Tanturovski
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Labor ◽  
Cervical Length ◽  
Outcome Variable ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Tnf Α ◽  
Vaginal Swabs ◽  
The Relationship

AbstractThe aim of this study was to determine the relationship between sonographic cervical length, fetal fibronectin (fFN), phIGFBP-1 (actim partus test), cytokines (IL-6, IL-2R, and TNF-α), and spontaneous preterm birth (SPTB) up to 14 days from sampling.Fifty-eight patients were recruited in a period of 6 months from September 2013 until March 2014 with symptoms or complaints suggestive of preterm labor. Consenting women were treated according to usual hospital protocol, with addition of vaginal swabs taken for fetal fibronectin, phIGFBP-1 (actim partus test) and cervical IL6, IL2R, and TNF-α. The outcome variable was occurrence of preterm delivery within 14 days from the day of hospital admission.Thirty-six patients (62.07%) were delivered within 14 days from admission. Our results indicated that the cervical length significantly inversely correlates with the concentration of IL-6 in the CVF (Spearman’s coefficient R=–0.382, P<0.05). Cervical length also correlated with a positive phIGFBP-1 test, i.e., patients with a positive test had an average cervical length of 18.5±4.63 mm, which is significantly lower than patients with a negative test –23.43±7.39 mm (P=0.003).The studied biochemical markers were only moderately successful in the prediction of preterm delivery.

Betamethasone as a potential treatment for preterm birth associated with sterile intra-amniotic inflammation: a murine study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jose Galaz ◽  
Roberto Romero ◽  
Marcia Arenas-Hernandez ◽  
Bogdan Panaitescu ◽  
Robert Para ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Ultrasound Guidance ◽  
Perinatal Outcomes ◽  
High Mobility ◽  
Preterm Births ◽  
Standard Of Care ◽  
Perinatal Morbidity ◽  
Gestational Length ◽  
Phosphate Buffered Saline

Abstract Objectives Preterm birth remains the leading cause of perinatal morbidity and mortality worldwide. Preterm birth is preceded by spontaneous preterm labor, which is commonly associated with sterile intra-amniotic inflammation; yet, no approved treatment exists for this clinical condition. Corticosteroids are the standard of care to improve neonatal outcomes in women at risk of preterm birth. Herein, we first validated our model of alarmin-induced preterm birth. Next, we investigated whether treatment with betamethasone could prevent preterm birth resulting from sterile intra-amniotic inflammation in mice. Methods Under ultrasound guidance, the first cohort of dams received an intra-amniotic injection of the alarmin high-mobility group box-1 (HMGB1, n=10) or phosphate-buffered saline (PBS, n=9) as controls. A second cohort of dams received HMGB1 intra-amniotically and were subcutaneously treated with betamethasone (n=15) or vehicle (n=15). Dams were observed until delivery, and perinatal outcomes were observed. Results Intra-amniotic HMGB1 reduced gestational length (p=0.04), inducing preterm birth in 40% (4/10) of cases, of which 100% (4/4) were categorized as late preterm births. Importantly, treatment with betamethasone extended the gestational length (p=0.02), thereby reducing the rate of preterm birth by 26.6% (from 33.3% [5/15] to 6.7% [1/15]). Treatment with betamethasone did not worsen the rate of neonatal mortality induced by HMGB1 or alter weight gain in the first three weeks of life. Conclusions Treatment with betamethasone prevents preterm birth induced by the alarmin HMGB1. This study supports the potential utility of betamethasone for treating women with sterile intra-amniotic inflammation.

scholarly journals Fetal Fibronectin Test Performance in Patients at Low Risk for Preterm Delivery

2018 ◽  
Vol 8 (4) ◽  
pp. 347-352
Author(s):  
Sumithra Jeganathan ◽  
Alexander G. Shilkrut ◽  
Aleksandr M. Fuks ◽  
Sari J. Kaminsky
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Test Performance ◽  
Preterm Labor ◽  
Hospital Admissions ◽  
Low Risk ◽  
Test Results ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Steroid Administration

Objectives: Spontaneous preterm birth is a leading cause of neonatal death. Fetal fibronectin (fFN) testing in cervical secretions between 22-34.6 weeks of gestation is used to predict non-delivery within the next 7 days in patients with symptoms of preterm labor. The objective of this study is to analyze fFN test performance in a group of patients with low risk for preterm delivery that presented with preterm labor symptoms, and to evaluate how the results of fFN testing influenced management decisions. Materials and Methods: Patients after preterm delivery (gestational age 24.0-36.6 weeks) and patients who underwent fFN testing in Metropolitan Hospital, NYC Health+Hospitals, New York, NY, from January 1, 2015 to December 31, 2015 were identified and reviewed. Patients with positive fFN test results (fFN+; >50 ng/dL) were compared to patients with negative fFN test results (fFN-). Results: Among 77 patients identified, 66 (86%) were fFN- and 11 (14%) fFN+; 15 patients (78%) who delivered preterm were not tested with fFN. Preterm birth rate during the study period was 1.9%. There was no difference in maternal or neonatal characteristics between the two groups. Among fFN-, 4 patients (6%) delivered preterm, while among fFN+, none delivered preterm. In both groups, none delivered within 7 days of testing. Compared to fFN-, fFN+ had higher rates of admissions (36% vs 0%; P<0.001) and steroid administration (82% vs 0%; P<0.001). Conclusions: In this retrospective analysis, use of fFN testing as an initial screening test for patients with symptoms of preterm labor in this low risk population did not result in improved clinical outcomes and was associated with a higher rates of hospital admissions and steroid administration.

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