Clinical and biochemical markers of spontaneous preterm birth in singleton and multiple pregnancies

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

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PF.02 The Role of Quantitative Fetal Fibronectin and Cervical Length in Predicting Spontaneous Preterm Birth in Multiple Pregnancies

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2013-303966.014 ◽

2013 ◽

Vol 98 (Suppl 1) ◽

pp. A5.1-A5 ◽

Cited By ~ 1

Author(s):

R Mapara ◽

DS Abbott ◽

NL Hezelgrave ◽

AH Shennan

Keyword(s):

Preterm Birth ◽

Cervical Length ◽

Multiple Pregnancies ◽

Spontaneous Preterm Birth ◽

Fetal Fibronectin

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Biochemical Markers of Spontaneous Preterm Birth in Asymptomatic Women

BioMed Research International ◽

10.1155/2014/164081 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 14

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.

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“Relaxin-dependent” way of implementing spontaneous preterm labor in multiple pregnancies: The involvement of placental relaxin 2

Journal of obstetrics and women s diseases ◽

10.17816/jowd60946 ◽

2021 ◽

Vol 70 (2) ◽

pp. 27-36

Author(s):

Olga V. Pachuliya ◽

Olesya N. Bespalova ◽

Mariya G. Butenko ◽

Yulia P. Milyutina ◽

Tatyana G. Tral ◽

...

Keyword(s):

Preterm Birth ◽

Histological Examination ◽

Preterm Labor ◽

Multiple Pregnancy ◽

Chorionic Villus ◽

Multiple Pregnancies ◽

Spontaneous Preterm Birth ◽

Wide Range ◽

Relaxin 2 ◽

Term Labor

BACKGROUND: Despite numerous studies, the etiopathogenesis of preterm birth in multiple pregnancy remains unclear, which determines the low effectiveness of measures for the prevention of preterm birth. This fact makes it necessary to study possible ways of implementing preterm birth in multiple pregnancies and to search for new biomarkers of their pathogenetic links. Experimental and clinical studies have demonstrated the contribution of the pleiotropic hormone relaxin to the regulation of a wide range of physiological processes and its role in the implementation of the pathogenetic mechanisms of pregnancy complications, primarily premature birth. The proven autocrine / paracrine mechanism of placental relaxin action, which implements important local effects, determines the prospects for studying the contribution of its dysregulation to the implementation of spontaneous preterm labor in multiple pregnancies. MATERIALS AND METHODS: A morphological examination of 92 placentas from 46 deliveries of dichorionic diamniotic twins was performed: 24 of them were spontaneous premature births and 22 spontaneous term births. Histological examination of placentas along with immunohistochemical verification of relaxin 2 expression in the chorionic villus of the dichorial twins placentas were carried out. RESULTS: Histological examination of the dichorionic twins placentas revealed that those from spontaneous preterm birth were characterized by a higher frequency of chronic placental insufficiency with reduced compensatory and adaptive mechanisms and more pronounced circulatory disorders in the circulatory bed of the villous tree, when compared to placentas from spontaneous term labor. The first verification of relaxin 2 expression in the chorionic villi of the dichorionic twins placenta showed the role of the peptide in the initiation of spontaneous preterm birth. The relative area of relaxin 2 expression in spontaneous preterm labor was significantly higher (p 0.05) compared to that in spontaneous term labor. CONCLUSIONS: The data obtained confirm the hypothesis put forward about the involvement of placental relaxin in the pathogenesis of spontaneous preterm labor in multiple pregnancies. The authors were the first to propose the definition of a relaxin-dependent way of implementing spontaneous preterm labor. To help define new preventive strategies, the prospects for further studies of the role and significance of relaxin in the implementation of pathogenic processes involved in spontaneous preterm birth in multiple pregnancies have been outlined.

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The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: A randomized trial

10.21203/rs.2.13317/v2 ◽

2020 ◽

Author(s):

Mona Aboulghar ◽

Yahia El-Faissal ◽

Ahmed Kamel ◽

Ragaa Mansour ◽

Gamal Aboulserour ◽

...

Keyword(s):

Preterm Birth ◽

Birth Rate ◽

Previous History ◽

Secondary Outcome ◽

Base Line ◽

Multiple Pregnancies ◽

Spontaneous Preterm Birth ◽

Preterm Birth Rate ◽

Twin Pregnancies ◽

Natural Progesterone

Abstract Background: The rate of multiple pregnancies in IVF/ICSI ranges from 20-30% . The incidence of preterm birth in multiple pregnancies is as high as 60% and is even higher in pregnancies conceived after IVF & ICSI. The effect of progesterone on prevention of preterm birth in twins is controversial . Our group has proven a positive effect in reduction of preterm birth ,by starting progesterone from the mid-trimester ,in exclusively IVF/ICSI singleton pregnancies but not twins. The purpose of our current study was to explore the effect of earlier administration of natural progesterone, in IVF/ICSI twin pregnancies starting at 11-14 weeks for prevention of preterm birth. Methods: This is a double-blind, placebo controlled, single center, randomized clinical trial. Women with dichorionic twin gestations, following an IVF/ICSI trial were randomized to receive natural rectal progesterone (800 mg daily ) vs placebo, starting early from 11-14 weeks. They were randomized regardless of cervical length and had no previous history of preterm birth or known Mullerian anomalies. The primary outcome was, spontaneous preterm birth rate <37 weeks. The secondary Outcome was; spontaneous preterm birth <34,32,28 weeks and neonatal outcome. Results: A total of 203 women were randomized to both groups, final analysis included 199 women as 4 were lost to follow up. The base line characteristics as well as gestational age at delivery were not significantly different between the study and the placebo group (34.7±3.6 vs 34.5±4.5, P=0.626). Progesterone administration was not associated with a significant decrease in the spontaneous preterm birth rates <37 weeks (73.5% vs 68%, P = 0.551), <34 (20.6% vs 21.6%, P = 0.649), <32 (8.8% vs 12.4%, P = 0.46) & <28 (4.9 % vs 3.1 %, P = 0.555). Conclusions: Rectal natural progesterone starting from the first trimester in IVF/ICSI twin pregnancies did not reduce spontaneous preterm birth.The trial was registered on 31 January 2014 at www.ISRCTN.com, 69810120.

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