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Preterm labor tests: current status and future directions
Wei Huang1, Serdar Ural2, Yusheng Zhu1
1Department of Pathology and Laboratory Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Insights
Early diagnosis of preterm labor (PTL) is crucial for reducing preterm birth (PTB) and neonatal mortality. This review analyzes current biomarker performance and utility, exploring future omics-based diagnostics for improved PTL prediction.
Area of Science:
- Neonatal Healthcare
- Reproductive Medicine
- Clinical Diagnostics
Background:
- Preterm birth (PTB) is a leading cause of neonatal mortality and a significant healthcare burden.
- Current diagnosis of preterm labor (PTL) relies on inaccurate clinical criteria.
- Existing biomarkers for PTL show variable diagnostic performance.
Purpose of the Study:
- To analyze the performance characteristics (sensitivity, specificity, PPV, NPV) of current PTL biomarkers.
- To evaluate the clinical utility and limitations of existing PTL diagnostic tests.
- To summarize current recommendations for PTL biomarker utilization in clinical practice.
Main Methods:
- Systematic review and analysis of published data on PTL biomarkers.
- Evaluation of diagnostic performance metrics for various biomarkers.
- Assessment of clinical utility based on sensitivity, specificity, and predictive values.
Main Results:
- Current PTL biomarkers exhibit a range of diagnostic accuracies.
- Understanding biomarker performance is essential for appropriate clinical application.
- There is a need for more accurate and reliable methods for PTL prediction.
Conclusions:
- Accurate early diagnosis of PTL is critical for improving neonatal outcomes.
- Current biomarkers have limitations that necessitate careful interpretation.
- Future research into omics-based biomarkers holds promise for enhanced PTL prediction.
Abstract:
Preterm labor (PTL) is a severe issue of neonatal healthcare because its related to preterm birth (PTB) is the leading cause of neonatal mortality and the most common reason for antenatal hospitalizations. The PTB rate is about 11% globally and it is similar in the United States. PTB poses a significant economic burden on the healthcare system. Early diagnosis of PTL is the key to reducing PTB rate, neonatal mortality, and long-term neurological impairment in children. The diagnosis of PTL is usually based on clinical criteria, but the accuracy of the diagnosis is poor. To predict the risk of PTL more accurately, tests of biomarkers with variable clinical diagnostic performances have been developed and some of them have been applied clinically. In this article, we analyze the performance characteristics of these biomarkers, such as sensitivity, specificity, positive predictive value, and negative predictive value, as well as the clinical utility of current biomarkers so that clinical laboratorians and clinicians can better understand the limitations of these tests and utilize them wisely. We also summarize the current recommendations on clinical utilization of PTL biomarkers. Finally, we explore the prospects of future omics-based novel biomarkers, which may improve prediction of PTL in the future.
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