title: Prediction of spontaneous preterm labour in at-risk pregnant women.
abstract: The ability to recognise women who are at-risk of preterm labour (PTL) is often difficult. Over 50% of women who are identified with factors associated with an increased risk of preterm birth will ultimately deliver at term. The cervicovaginal fluid (CVF) comprises a range of proteins secreted by gestational tissues, making it an ideal candidate for the screening of differentially expressed proteins associated with PTL. CVF samples were collected from at-risk asymptomatic women. Two-dimensional gel electrophoresis techniques were used to examine the CVF proteome of women who spontaneously delivered preterm 11-22 days later compared with gestation-matched women who delivered at term. Five candidate biomarkers were selected for further validation in a larger independent cohort of asymptomatic women. Thioredoxin (TXN) and interleukin 1 receptor antagonist (IL1RN) concentrations in the CVF were found to be significantly reduced up to 90 days prior to spontaneous PTL compared with women who subsequently delivered at term. TXN was able to predict spontaneous PTL within 28 days after sampling with a high positive predictive value (PPV) and negative predictive value (NPV) of 75.0% and 96.4% respectively. IL1RN also showed comparable PPV and NPV of 72.7% and 95.7% respectively. The discovery of these differentially expressed proteins may assist in the development of a new predictive bedside test in identifying asymptomatic women who have an increased risk of spontaneous PTL.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Stella
authors.initials: S
authors.lastname: Liong
authors.forename: Megan K W
authors.initials: MK
authors.lastname: Di Quinzio
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Fleming
authors.forename: Michael
authors.initials: M
authors.lastname: Permezel
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Rice
authors.forename: Harry M
authors.initials: HM
authors.lastname: Georgiou
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D001826:Body Fluids / Q000378:metabolism*; D016022:Case-Control Studies; D015331:Cohort Studies; D015180:Electrophoresis, Gel, Two-Dimensional; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000378:metabolism; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis* / Q000378:metabolism; D020543:Proteome / Q000032:analysis*; D040901:Proteomics; D012307:Risk Factors; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D014621:Vagina / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020543:Proteome