SIGNIFICANCE OF EARLY MARKERS OF PREGNANCY FOR PRETERM DELIVERY

The goal of the paper is to examine the clinical utility of the first-trimester maternal serum levels of pregnancy-associated plasma protein-A and free beta-human chorionic gonadotropin with regards to their ability to predict preterm delivery. As part of the screening for trisomy 21, 700 pregnant women were tested for values ​​of pregnancy-associated plasma protein-A (PAPP-A) and free beta- human chorionic gonadotropin (freeβ-hCG), combined with the nuchal translucency (NT). The analysis showed that the age of the pregnant women correlated with whether or not they had preterm delivery, whereby a statistically highly significant difference was found (χ2 = 19.320; df = 2; p < 0.01), as consequence of the fact that the younger women did not have preterm delivery much more frequently (100.0%) in comparison with the middle-aged and older women from the study (90.5% and 77.9% respectively). Furthermore, the analysis in which we took account of the number of earlier abortions presented a statistically substantial difference (F = 14.384; df = 5; p < 0.05), showing that women with no preterm delivery often had no earlier abortions (80.1%), as opposed to those who did (70.0%). Therefore, hormones could not be used individually as a clinical test for the preterm delivery prediction; nevertheless, this is an important finding because it may enable the development of an algorithm to estimate an individualized risk of preterm delivery based on multiple factors, including the first-trimester biochemical markers. The clinical value of using these hormonal levels to predict and manage preterm delivery requires further investigation.