Scienti c update by

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Scientific update on Prevention of Preterm Labour

Prediction of spontaneous preterm birth and

preterm prelabor rupture of membranes using
biomarkers of placental function at 11–13 weeks
Nov 2023

Spontaneous preterm birth (sPTB) has heterogenous etiologies.

One risk factor with limited predictability ability for subsequent
pPTB is history of PTB especially if used as a single predictor.
Others are advancing maternal age, obesity, conception using
in-vitro fertilization, smoking and pre-existing medical diseases.
sPTB may be a manifestation of the placental insufficiency spectrum,
sharing similar underlying placental pathology with pre-eclampsia.

A retrospective secondary analysis was carried out on data derived

from a prospective cohort study, included, 9298 first trimester
singleton pregnancies attending routine screening between
11 -13 weeks of gestation.

In the study, sPTB at <37 weeks occurred in 362 (3.89%) cases,

including 231 (2.48%) cases of PPROM. sPTB at <34 weeks
occurred in 87 (0.94%) cases, including 39 (0.42%) cases of PPROM

Novel Findings in this Study:

First-trimester maternal serum pregnancy-associated plasma
protein-A (PAPP-A) and placental growth factor (PlGF) levels are
reduced in cases of spontaneous preterm birth (sPTB) and preterm
For the use only of a Registered Medical Practitioner or a Hospital or a Laboratory.

prelabor rupture of membranes (PPROM) at <37 weeks, suggesting

that placental insufficiency is implicated in the underlying
pathophysiology of these complications.

Clinical Implications of this study were:

In addition to increased risks of fetal growth restriction and
pre-eclampsia, low levels of maternal serum PAPP-A and PlGF are
associated with increased risks of sPTB and PPROM.
These findings may be useful in counseling women regarding their
obstetric risks, and paving the way to the identification of effective
personalized preventive measures for women at high risk of sPTB.

Reference:
Hui Kan, Haiyan Liu, Yutong Mu, Yijie Li, Miao Zhang, Yanmin Cao, Yao Dong, Yaxin Li, Kailin Wang, Qing Li, Anqun Hu, Yingjie
Zheng, Novel genetic variants linked to prelabor rupture of membranes among Chinese pregnant women, Placenta,
10.1016/j.placenta.2023.04.007, 137, (14-22), (2023).

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