Biomarkers Can Predict Preterm Birth Risk Earlier In Pregnancy Than Ever Before
The World Health Organization estimates around 15 million babies are born too early or preterm each year. Worse yet, this number continues to rise throughout the globe for no clear reason. Preterm birth is associated with several complications, and it's the leading cause of death among children aged 5 and under. A new study from King’s College London, however, may give hope to expectant mothers, as it's found a way to identify at-risk mothers faster than before.
There are a number of factors that can help determine a woman’s risk for preterm birth, including history of preterm births or miscarriages, the length of the woman's cervix, and levels of fetal fibronectin, a biomarker found in vaginal fluids. Measurements of these fluids are typically taken at 22 to 27 weeks of pregnancy. The current study, however, investigated whether they could be taken even earlier while still providing accurate readings.
According to the National Institutes of Health, a biomarker (or biological marker) is a general term used to describe any substance in the body that can be used to indicate and measure a biological process. It is most often used to determine whether the body is functioning normally or to study the body's reaction to a certain medication or treatment. Specific proteins in blood, for example, can be used as biomarkers to indicate the presence of mental health conditions, such as bipolar disorder.
For the study, the researchers looked at fetal fibronectin levels in 898 high-risk asymptomatic women who were between 18 and 21 weeks gestation, and then again when they were between 22 and 27 weeks gestation. When paired with the time the women delivered, the researchers found the earlier measurements offered a similar predictive value to measurements taken later in the pregnancy. When these tests were combined with measurements of cervical length, the diagnostic accuracy was further improved.
"Tests to tell us who to treat have been poor in the first half of pregnancy," lead researcher Dr. Andrew Shennan told Medical Daily in an email. "At last we have a test that could allow us to target these treatments early enough to be beneficial."
While these results are promising, the authors urged in a recent statement that the findings still shouldn’t be the deciding factor between using an early test rather than a later one — not until more research proves it’s effective, at least. Still, with preterm birth being the serious health condition it is, and affecting 5 to 18 percent of babies born across the world, being able to offer earlier treatments to women who are at highest risk would have lasting effects.
Shennan concluded, "We can also reassure lots of high-risk women earlier and prevent unnecessary worrying and follow up."
Source: Shennan A, Hezelgrave N, Abbott D, et al. Quantitative Fetal Fibronectin at 18 Weeks of Gestation to Predict Preterm Birth in Asymptomatic High-Risk Women. Obstetrics & Gynecology. 2016.