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Updated: Aug 5, 2026
FISH for Pre-implantation Genetic Diagnosis
Published on: February 23, 2011
From phenotype-based to biology-driven screening for preterm birth risk: an expert European perspective
Gian Carlo Di Renzo1, Nandor Acs2, Jose Luis Bartha3
1PREIS International and European School of Perinatal, Neonatal and Reproductive Medicine, Florence, Italy; Department of Obstetrics, Gynaecology and Perinatal Medicine , I.M. Sechenov First State University of Moscow, Moscow, Russia; Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
Insights
Preterm birth (PTB) prediction needs better methods beyond clinical factors. A syndromic approach and maternal serum biomarker tests show promise for improving risk screening and reducing adverse outcomes.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Public Health
Background:
- Preterm birth (PTB) is a major public health issue with significant neonatal morbidity and mortality.
- Current risk screening methods for PTB have limited predictive power due to reliance on clinical factors not present in all affected individuals.
- PTB is a heterogeneous syndrome, necessitating a move beyond single-marker prediction to a more comprehensive biological understanding.
Purpose of the Study:
- To discuss the current state of preterm birth risk screening in Europe.
- To advocate for a 'syndromic' approach to PTB risk assessment, acknowledging its heterogeneous nature.
- To explore the potential of maternal serum biomarker tests in improving PTB risk screening.
Main Methods:
- Expert opinion review of current PTB risk screening strategies.
- Discussion of the limitations of clinical risk factors in PTB prediction.
- Introduction of a maternal serum biomarker test (PreTRM®) as a potential solution.
Main Results:
- Current clinical risk factors are insufficient for accurate PTB prediction.
- A syndromic view of PTB is crucial for developing effective screening tools.
- Maternal serum biomarker tests offer a potential advancement in PTB risk assessment.
Conclusions:
- Future PTB risk screening should integrate biological insights beyond clinical indicators.
- A syndromic approach is essential for addressing the complexity of PTB.
- Biomarker tests like PreTRM® may help mitigate PTB and associated neonatal complications.
Abstract:
Preterm birth (PTB) remains a significant public health concern despite advances in obstetric and neonatal care. Risk screening methods have modest predictive power, primarily because they rely on clinical risk factors that are not present in most women who experience a PTB. Unlike a single disease entity, PTB is a heterogeneous syndrome caused by various genetic, clinical, and environmental factors, and therefore, cannot be predicted by a single marker or risk indicator. For this reason, current risk assessment methods must be shifted from purely clinical indicators to ones that can also capture the underlying biology of the process. This expert opinion piece discusses the current state of risk screening in Europe and the importance of using a 'syndromic' rather than a 'single disease' view of PTB to guide future risk screening. A validated maternal serum biomarker test, marketed in the United States under the tradename PreTRM®, is also discussed as a tool that could potentially help address key shortcomings of risk screening methods, and thereby aid efforts to mitigate PTB, neonatal morbidity and mortality, and their associated costs.
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