International Journal of Clinical Obstetrics and Gynaecology

Preterm labor remains one of the leading challenges in obstetrics, contributing significantly to perinatal morbidity and mortality worldwide. Although several factors have been associated with its onset, growing evidence suggests that inflammation and subclinical intrauterine infections play a major role in the pathogenesis of preterm labor. Among the various biochemical markers under investigation, serum ferritin and C-reactive protein (CRP) have emerged as promising indicators due to their established roles in inflammatory pathways. This prospective case-control study, conducted in the Department of Obstetrics and Gynaecology at SCB Medical College and Hospital, Cuttack, from June 2020 to May 2021, aimed to evaluate the predictive value of maternal serum ferritin and CRP levels in preterm labor.
A total of 200 pregnant women were recruited and categorized into two groups: Group A (cases) comprised 100 women experiencing spontaneous preterm labor between 30 and 34 weeks of gestation, and Group B (controls) included 100 women with uncomplicated term pregnancies. Serum ferritin and CRP levels were measured using chemiluminescence immunoassay. Statistical analyses revealed significantly higher serum ferritin (38.04±4.04 ng/mL vs. 14.49±4.55 ng/mL) and CRP levels (5.31±1.33 mg/L vs. 1.50±0.29 mg/L) in the preterm group compared to the term group (P=0.001 for both). A strong positive correlation between ferritin and CRP was observed only in the preterm group (r=0.735, P=0.001), indicating a distinct inflammatory profile. Furthermore, ROC analysis demonstrated high diagnostic accuracy for serum ferritin in predicting preterm labor.
These findings underscore the potential role of serum ferritin and CRP as valuable biomarkers for early identification of women at risk of preterm labor. Incorporating these markers into routine antenatal screening may enable timely interventions, thereby improving maternal and neonatal outcomes. However, larger multicenter studies are needed to validate these findings and clarify the combined predictive value of these biomarkers.