Prediction of Preterm Delivery among Low-risk Indian Pregnant Women: Discriminatory Power of Cervical Length, Serum Ferritin, and Serum Alpha-fetoprotein.

ABSTRACT

Background: Around 80% of preterm births (PTBs) occur spontaneously. Various biomarkers are being evaluated to assess the possible role of chorioamniotic inflammation in PTBs. Aim: The aim of this study was to establish the accuracy of serum bio-markers( cut off values of ferritin and alpha-fetoprotein [AFP] at midtrimester) along with cervical length [CL] assessment to predict preterm delivery among low-risk women. Methods: Three hundred low-risk pregnant women attending the antenatal clinic of a tertiary health care facility were included and underwent CL measurement during mid-trimester by transvaginal ultrasonography and their serum levels of ferritin and AFP were recorded. All were followed up till delivery. Results: Receptor-operated characteristic curves for ferritin, AFP, and CL were constructed. Area under curves and Youden Index calculated for each marker were very low (<0.5) which is statistically considered very poor for a screening test. Conclusion: Serum ferritin and AFP together with CL measurement in the second trimester of pregnancy had poor discriminatory value in predicting preterm delivery among low-risk asymptomatic pregnant women.