Cervicovaginal prolactin: a marker for spontaneous preterm delivery

Area of Science:

• Reproductive Medicine
• Biochemistry
• Obstetrics

Background:

• Preterm birth remains a leading cause of neonatal morbidity and mortality.
• Accurate prediction of preterm birth is crucial for timely intervention and improved outcomes.
• Biochemical markers in cervicovaginal secretions offer a potential non-invasive method for risk assessment.

Purpose of the Study:

• To investigate the association between cervicovaginal prolactin levels and preterm birth.
• To evaluate the predictive value of cervicovaginal prolactin for delivery at or before 34 weeks' gestation.
• To assess the relationship between cervicovaginal prolactin and latency to delivery and birth weight.

Main Methods:

• A cohort of 80 patients, including 40 inpatients requiring tocolysis and 40 asymptomatic outpatients, underwent cervicovaginal washing.
• Radioimmunoassay was used to quantify prolactin concentrations in the collected samples.
• A positive test result was defined as a prolactin concentration exceeding the assay's detection limit.

Main Results:

• Prolactin was detected in 50% of symptomatic patients versus 5% of asymptomatic controls (p < 0.0001).
• In symptomatic patients, cervicovaginal prolactin demonstrated an 80% positive predictive value and 65% negative predictive value for delivery at <= 34 weeks' gestation.
• Patients with positive prolactin tests experienced shorter latency to delivery (16 vs 34 days, p = 0.02) and lower birth weights (1985 vs 2583 gm, p = 0.01).

Conclusions:

• Cervicovaginal prolactin serves as a biochemical marker for preterm delivery, shorter latency, and lower birth weight in symptomatic patients.
• The findings suggest that cervicovaginal prolactin may also be a valuable marker for predicting preterm birth in asymptomatic women.
• Further research is warranted to validate these findings and explore clinical applications of this biomarker.