Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks of pregnancy. While most babies born this early survive, preterm birth can cause serious health problems. Promoting the health of pregnant women and developing ways to prevent preterm birth are important public health priorities.
Causes of Preterm Birth
There are several potential factors that can increase the risk of preterm birth including prior preterm births, infections, multiple pregnancies, smoking, stress, chronic health conditions in the mother like high blood pressure and diabetes, and socioeconomic factors like poverty and lack of prenatal care. However, the underlying reasons for preterm birth remain unknown in around half of all cases. Researchers are actively working to better understand the biological mechanisms involved.
Prom Testing for Predicting Risk
One promising area of research is the use of novel screening tests to help identify women at highest risk of Preterm Birth and Prom Testing in early in pregnancy. Proteomic biomarkers, also known as proteomics-based tests or prom tests, measure multiple protein biomarkers in maternal blood that have been associated with preterm birth. These proteomic panels, if validated, could help target intensive prenatal care and prevention strategies to those most likely to benefit.
A 2020 study published in the American Journal of Obstetrics and Gynecology investigated the use of a proteomic test called the Proteomic Assessment of Preterm Risk (PAPR) test. The study involved over 2,000 pregnant women between 24-34 weeks of gestation. The PAPR test analyzed the expression of 25 specific proteins in maternal blood associated with biological pathways involved in placental function and parturition. The risk scores were then compared to actual birth outcomes.
The researchers found the PAPR score was highly effective at predicting which women would deliver Preterm Birth and Prom Testing with an area under the receiver operating characteristic curve of 0.82. A high PAPR score was associated with a significantly increased risk, with an odds ratio of nearly 5. The test had a high sensitivity of 74% and specificity of 66%, meaning it identified most women who did experience preterm birth while avoiding false alarms in most who did not.
If validated in broader populations, proteomic tests like PAPR could be a useful clinical tool for identifying those at high preterm birth risk who may benefit most from aggressive interventions. Larger prospective studies are still needed but initial results are promising. Combining proteomic testing with other clinical risk factors may further improve prediction. Widespread implementation could help reduce the preterm birth rate.
Other Biomarkers Under Investigation
Along with proteomic panels, researchers are exploring many other potential molecular biomarkers for preterm birth prediction. Cervical length measurement via transvaginal ultrasound is an established clinical assessment but on its own has limited predictive value especially in late preterm birth risk ranging from 34-36 weeks gestation. Vaginal progesterone supplementation has been shown to reduce preterm birth in high-risk women but targeting is imperfect.
Some biomarkers being actively investigated include fetal fibronectin, placental alpha-microglobulin-1, cervical-vaginal microbiome characterization via molecular techniques, placental growth factor, placental protein 13,angiogenic factors, cytokines and inflammatory markers. Metabolomic profiling of maternal blood, urine and vaginal secretions is another area gaining interest. There is hope that combining clinical risk factor assessment with multiple biomarker modalities may significantly strengthen predictive performance, guiding interventions to those facing genuine elevated risk. However, replication across diverse populations will be essential before widespread implementation.
ImprovingBirth Outcomes Through Prevention
If proteomic tests or combinations of molecular markers can reliably forecast preterm birth with high sensitivity and specificity, this could open ways to proactively mitigate risks. For instance, high-risk patients may benefit from additional cervical length monitoring, prophylactic progesterone, avoidance of unnecessary cerclage procedures, close infection screening and timely treatment. Changes in weight bearing, work duties and reduced stress may lower physical demands on the pregnant body. Social support interventions may help disadvantaged groups. Trials of diet/nutritional supplementation are also underway given potential influences of micronutrient status.
With further refinement, multi-modal biomarker guided protocols tailored for individual women could drive down preterm birth rates on a population scale. However, research efforts must consider socioeconomic barriers some may face in accessing advanced testing and follow-up care. Public health strategies should seek equitable solutions for all. Ultimately, the goal is optimizing fetal outcome through anticipatory, evidence-based maternal care guided by predictive accuracy into which proteomics shows promise to contribute significantly.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it