Analysis of modern markers of spontaneous preterm birth

Preterm birth (PВ) is an important problem of modern obstetrics and the main cause of morbidity and mortality among newborns worldwide. Aim - to evaluate the clinical and anamnestic status of women with spontaneous preterm birth and to determine the role of certain haematological parameters and melatonin as prognostic markers of PB, development of pregnancy and delivery complications in such patients. Materials and methods. The main study group included 57 women whose pregnancy ended in PB at 24-36 weeks of gestation. The control group consisted of 30 patients who had term labour. We studied the obstetric, gynaecological and somatic anamnesis of patients, including the history of pregnancy, childbirth and the postpartum period, clinical and laboratory parameters, including melatonin levels. Results. Significant differences were found in the frequency of preterm birth in the history, which was reported by 14.0% of women in the main group and none of the patients in the control group. The percentage of women in the main group with a history of 3 or more abortions (artificial and spontaneous) was 4.8 times higher than in the control group. The overall incidence of pregnancy complications in the main group was twice as high as in the control group. The activation of the inflammatory process was confirmed by significantly increased levels of leukocytes (1.3 times) and C-reactive protein (4.9 times) in the blood serum of women in the main group. A 3.5-fold decrease in melatonin in the saliva of women with PB was found compared to the control group. Conclusions. Among the main risk factors for spontaneous PB were the presence of a history of preterm birth, 3 or more abortions and miscarriages, concomitant gynaecological pathology, as well as a complicated course of pregnancy with cases of threatened abortion in the first and second trimesters and anaemia in the second trimester. The risk of PB was directly associated with increased levels of C-reactive protein, leukocytes, neutrophil/lymphocyte ratio, mean platelet volume and platelet distribution width, and inversely with melatonin production and magnesium levels. This allows us to consider these indicators as possible markers of preterm birth prediction. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the local ethics committee. Informed consent was obtained from the patients. The authors declare no conflict of interest.