Perinatal Biomarkers for Predicting Preterm Birth and Neonatal Intensive Care Requirements

Abstract

Background:
Preterm birth is a major cause of neonatal morbidity and mortality worldwide. Perinatal biomarkers for early detection of high risk pregnancies may help to direct timely interventions and improve neonatal outcomes. Fetal fibronectin, cervical length, C-reactive protein (CRP) and inflammatory cytokines are promising biomarkers for predicting preterm delivery and neonatal intensive care unit (NICU) admission.

Objective:
To evaluate the use of selected perinatal biomarkers in the prediction of preterm birth and neonatal intensive care.
Methodology:
A prospective cohort study was performed on 250 pregnant women aged between 24 and 34 weeks of gestation. Maternal blood samples and cervix assessments were conducted to measure fetal fibronectin, CRP, interleukin-6 (IL-6) and cervical length. Neonatal outcomes and NICU admissions were obtained post-delivery.

Findings:
Preterm birth was present in 48 (19.2%) participants. Fetal fibronectin was elevated (> 50 ng/mL) in 72% of preterm cases. Mean IL-6 levels were significantly higher in the preterm group (14.8 ± 3.2 pg/mL) than in term deliveries (8.6 ± 2.5 pg/mL). NICU admission was required in 41 neonates (16.4%). The combined biomarkers predicted preterm birth with 87.5% accuracy and NICU admission with 84.2% accuracy.

Conclusion:
The perinatal biomarkers are useful tools for prediction of preterm birth and need of neonatal intensive care at early stage. Their incorporation into routine prenatal screening may improve risk stratification, allow for targeted clinical management, and lead to improved neonatal health outcomes.