Premature Birth Predicted by Immunoassay

A blood test has been developed that can predict the likelihood that women with intact membranes with threatened preterm labor will deliver spontaneously within seven days of sampling.

The test is based on testing maternal serum for specific proteins, using multiplex sandwich immunoassay based on flowmetric multiplex technology, which has been used to analyze multiple inflammatory markers and neurotrophins in maternal serum in women with threatened preterm labor (PTL).

From 1996 to 2005, an international team working at the Sahlgrenska University Hospital (Gothenburg, Sweden) enrolled 142 healthy women without major medical problems. The women were with singleton pregnancies presenting with threatened PTL between 22 weeks plus 0-7 days and 33 weeks plus 6-7 days of gestation. The assays were based on a newly developed blood test that looks at specific proteins in the woman's blood combined with an already established examination that uses ultrasound to measure the length of the cervix.

Only proteins with detectable maternal serum levels in more than 50% of the samples were included in the analyses. Therefore, interleukins (IL) such as IL-1b, IL-2, IL-5, IL-6, and IL-8 were excluded from further analyses. The statistically highest significant values were detected for IL-10, matrix metalloproteinasis-9 (MMP-9) and migration inhibitory factor (MIF). In the prediction model, levels of maternal serum IL-10 were significantly higher in women who delivered preterm within seven days of sampling, compared with women who delivered later. The study also showed that found that levels of maternal serum chemokine (C-C motif) ligand 5 (RANTES) were statistically higher in women who delivered compared with women who delivered later.

Panagiotis Tsiartas, MD, PhDc, the senior author of the study said, "To have time to give the woman cortisone, which speeds up the development of the fetal lungs, it is common practice to delay the delivery by a couple of days with the help of tocolytic treatment or anti-contraction medications. Being able to predict if a woman who comes to the hospital with preterm contractions will actually give birth early and thereby requires follow-up and possible treatment is therefore very important. Statistically, the method can predict with 75% to 80% accuracy if a woman will give birth early." The study was published September 2012 issue of the British Journal of Obstetrics and Gynaecology.

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Sahlgrenska University Hospital