Abstract: Background: Preterm birth is a major cause of neonatal and infant illness and mortality in developing countries. It is associated with severe suffering for both the mother and neonate as well as long-term disabilities; hence interventions to prevent preterm birth are critical. Therefore, accurate markers for determining whether a pregnant woman is at high risk for preterm delivery could lead to better surveillance and more timely intervention to improve outcomes.
Aims: To determine and compare predictive value of cervicovaginal β-Human Chorionic Gonadotropin (β-hCG) and Prolactin levels for preterm delivery in symptomatic women.
Materials & Methods: All the consenting eligible pregnant women between 28 to 36 weeks gestation who were hospitalized with symptoms of preterm labour were recruited for the study. One cervicovaginal fluid sample per woman was collected and quantitative estimation of β-hCG and Prolactin with Enzyme Linked Immunosorbent Assay (ELISA) kits was done. They were followed up till their delivery and divided into two groups depending on the outcome i.e., whether they had a term delivery or preterm delivery.
Results: A total of 40 women were involved in the analysis of which 28 (70%) progressed to have a preterm delivery and the rest 12 (30%) continued till term. The association between delivery outcome and mean cervicovaginal β-hCG and Prolactin levels was found to be statistically significant with p-value < 0.001. The optimal cut-off value for cervicovaginal β-hCG in predicting preterm delivery was reported to be greater than 15.54 mIU/ml, with specificity, sensitivity, negative predictive value and positive predictive value of 100%, 60.7%, 52.2%, and 100% respectively. Whereas, the specificity, sensitivity, negative predictive value and positive predictive value of cervicovaginal prolactin at a cut-off of greater than 6.24 ng/ml in predicting preterm delivery were found to be 83.3%, 89.29%, 76.9%, and 92.6% respectively. The area under the receiver operating characteristic (ROC) curve for cervicovaginal β-hCG and Prolactin levels was 0.820 and 0.920 respectively.
Conclusion: Cervicovaginal Prolactin level was found to be a better predictor of preterm delivery in symptomatic women when compared to cervicovaginal β-hCG level.
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