Serum Biglycan and Decorin as Biomarkers for Preterm Birth: A Prospective Cohort Study

Preterm birth (PTB) affects 10% of pregnancies worldwide, causing significant neonatal morbidity and mortality. Biglycan and decorin, essential proteoglycans in fetal membranes, are linked to spontaneous PTB pathophysiology. This study investigates their potential as biomarkers for spontaneous PTB.

This study included 500 pregnant women from various hospitals. Blood samples were collected, and participants were followed up until delivery. Pregnant women were categorized into groups based on gestational age at birth: moderate PTB, very PTB (vPTB), and term birth (control group). Serum levels of biglycan and decorin were measured using enzyme-linked immunosorbent assay kits. Statistical analysis included analysis of variance, logistic regression, and receiver operating characteristic curve evaluation using SPSS.

Serum levels of biglycan were higher in the vPTB group in the second (82.49 ± 2.86 pg/mL, P = 0.0012) and third trimesters (81.17 ± 2.01 pg/mL, P = 0.0097). In both trimesters, decorin levels were lower in the vPTB group (second: 36.32 ± 0.90 ng/mL, P = 0.0013; third: 34.25 ± 1.86 ng/mL, P = 0.0023). Receiver operating characteristic curve analysis showed fair discriminatory power for decorin in the third trimester (area under the curve = 0.70, P = 0.0021). Multinomial logistic regression further confirmed that both biomarkers (biglycan: OR 1.034, P = 0.001; decorin: OR 0.914, P = 0.001) were significant predictors of PTB.

Reduced amount of decorin and increased concentration of biglycan during pregnancy were associated with enhanced risk of spontaneous PTB. These results support the potential of early gestation serum glycoprotein complex as a predictive model for spontaneous PTB.