Biomarkers for predicting spontaneous preterm birth: an umbrella systematic review

Lucaroni, Francesca; Morciano, Laura; Rizzo, Giuseppe; Buonuomo, E.; Palombi, Leonardo; Arduini, D.

doi:10.1080/14767058.2017.1297404

Cited by 67 publications

(50 citation statements)

References 24 publications

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“…IL-6 is induced in decidual tissues at term in labor compared to not in labor (45) and therefore part of parturition. Nevertheless, while increased IL-6 levels were detected in maternal or fetal blood or amniotic fluid, this cytokine is also a well-established marker with an overall good diagnostic accuracy in identifying pregnancies at risk of spontaneous PTB (46)(47)(48). This is in agreement with our findings since the patients in our study delivering preterm had enhanced IL-6 level in plasma.…”

Section: Figure 3 |supporting

confidence: 92%

Regulatory B Cells Are Decreased and Impaired in Their Function in Peripheral Maternal Blood in Pre-term Birth

et al. 2020

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Preterm birth (PTB) is defined as birth before 37 completed weeks of gestation. The causes of PTB are multiple and complex, the underlying pathophysiology being largely unknown. Interferences in the fine-tuned balance of the maternal immune system have been pointed to as one possible cause of PTB. Regulatory B cells (Breg) are part of the adaptive immune response, and recent data suggest that they may contribute to a healthy pregnancy by their regulatory/suppressive function. We investigated the frequency of Breg cells in peripheral blood of women undergoing PTB and control women immediately before giving birth via cesarean section. We detected an enhanced number of B cells, but a reduced number of Breg cells in women delivering preterm. In addition, the percentage of IL-10-producing B cells was decreased in PTB following stimulation with TLR agonists CpG or LPS, alone or combined with CD40L. This was associated with increased levels of pro-inflammatory cytokines in maternal serum. Moreover, isolated maternal B cells before delivering premature babies secreted higher level of the pro-inflammatory cytokine IL-6. No alterations in the frequency of regulatory T cells were found. Our data indicate that alterations in the number and function of Breg cells in peripheral maternal blood contribute to the immunological changes observed in preterm delivery and suggest these cells as important regulators of maternal immune responses.

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Section: Figure 3 |supporting

confidence: 92%

Regulatory B Cells Are Decreased and Impaired in Their Function in Peripheral Maternal Blood in Pre-term Birth

et al. 2020

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“…Previous literature on cytokine activity related to PTB and LBW have reported significant relationships between (a) IL-6 and PTB (Lucaroni et al, 2018); and (b) IL-13 and IFNγ with LBW (Pearce et al, 2016). In our study, IL-6 showed a trend for a significant relationship with birthweight (r s = 0.388, p = 0.062) but did not show any significant correlations with the stress/emotional indicators.…”

Section: Discussioncontrasting

confidence: 48%

“…Inflammation has been used to identify dysregulation in previous AL studies and is relevant to PTB and LBW. Inadequate responses of the immune system measured at single time points (e.g., exaggerated inflammatory response measured as cytokines) in pregnant women with PTB have been previously identified (Lucaroni et al, 2018). Specifically, a systematic review authored by Lucaroni and colleagues (2018) reported increased interleukin-6 (IL-6) levels measured in maternal serum are associated with increased odds ratio of 2 (95%CI 1-3) and increased likelihood value of 12.…”

mentioning

confidence: 99%

Interleukin-17A and Chronic Stress in Pregnant Women at 24–28 Weeks Gestation

Moore¹,

Case

Mathews³

et al. 2019

Nursing Research

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Background: Allostatic Load (AL) is a biopsychosocial model that suggests chronic psychosocial stress leads to physiologic dysregulation and poor outcomes. The purpose of this study was to examine AL in pregnant women operationalized using pro-inflammatory cytokines and psychosocial indicators and perinatal outcomes. Objectives: In pregnant women, identify relationships between circulating cytokines/ chemokines and the Prenatal Distress Questionnaire (PDQ), Maternal Antenatal Attachment Scale (MAAS), Emotional and Quotient Inventory (EQi), Life Experiences Scale (LES), and demographics. Methods: A cross-sectional design was used to recruit pregnant women between 24-28 weeks gestation. Blood and stress/emotional indicators were obtained after informed consent. Plasma was abstracted to simultaneously measure 29 cytokines/chemokines using a multiplex array. Cytokine/ chemokine levels were compared with continuous variables using Spearman's Rho and with categorical variables using Mann-Whitney U.

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“…The digital cervical score [12] and Bishop score [13] as predictors of SPTD have demonstrated low diagnostic accuracy (61% -68%) [14]. Even though numerous risk factors associated with SPTD have been identified in previous work, the ability to accurately predict when labor will occur remains elusive [15] [16] [17] [18]. In a well-regarded, large observational cohort study, serial transvaginal ultrasound cervical length and quantitative vaginal fetal fibronectin had low predictive accuracy for SPTD among nulliparous women [19].…”

Section: Introductionmentioning

confidence: 99%

Cervical Characterization with Tactile-Ultrasound Probe

Egorov¹,

Rosen

Raalte³

et al. 2020

OJOG

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Background: Premature cervical softening and shortening may be considered an early mechanical failure that predisposes to preterm birth. Preliminary clinical studies demonstrate that cervical elastography may be able to quantify this phenomenon and predict spontaneous preterm delivery. Objective: To explore a new approach for cervix elasticity and length measurements with tactile-ultrasound probe. Methods: Cervix probe has tactile array and ultrasound transducer designed to apply controllable load to cervix and acquire stress-strain data for calculation of cervical elasticity (Young's modulus) and cervical length for four cervix sectors. Average values, standard deviations, intraclass correlation coefficients and the 95% limits of agreement (Bland-Altman plots) were estimated. Results: Ten non-pregnant and ten pregnant women were examined with the probe. The study with non-pregnant women demonstrated a reliable acquisition of the tactile signals. The ultrasound signals had a prolonged appearance; identification of the internal os of the cervix in these signals was not reliable. The study with pregnant women with the gestational age of 25.4 ± 2.3 weeks demonstrated reliable data acquisition with real-time visualization of the ultrasound signals. Average values for cervical elasticity and standard deviations of 19.7 ± 15.4 kPa and length of 30.7 ± 6.6 mm were calculated based on two measurements per 4 sectors. Measurement repeatability calculated as intraclass correlation coefficients between two measurements at the same cervix sector on pregnant women was found to be 0.97 for cervical elasticity and 0.93 for the cervical length. The 95% limits of agreement of 1) cervical elasticity were from −22.4% to +14.9%, and 2) cervical length from −13.3% to +16.5%. Conclusions: This study demonstrated clinically acceptable measurement performance and reproducibility. The availability of stress-strain data allowed the computation of cervical elasticity and length. This approach has the potential to provide cervical markers to predict spontaneous preterm delivery.

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Biomarkers for predicting spontaneous preterm birth: an umbrella systematic review

Cited by 67 publications

References 24 publications

Regulatory B Cells Are Decreased and Impaired in Their Function in Peripheral Maternal Blood in Pre-term Birth

Regulatory B Cells Are Decreased and Impaired in Their Function in Peripheral Maternal Blood in Pre-term Birth

Interleukin-17A and Chronic Stress in Pregnant Women at 24–28 Weeks Gestation

Cervical Characterization with Tactile-Ultrasound Probe

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