Utility of Placental Leucine Aminopeptidase/Oxytocinase in the Prediction of Preterm Delivery in Pregnant Women With Threatened Preterm Labor

Abstract

Objective: The study objective was to assess the utility of placental leucine aminopeptidase (P-LAP) marker for the prediction of delivery in patients presented with threatened preterm labor (TPL).
 Setting: This study was conducted at the Obstetrics and Gynaecology Department of Al-Yarmouk Teaching Hospital in the period from March 2017 to June 2018.
 Type of Study: This is a prospective case control study.
 Methods: This study included 90 pregnant women with gestational age from (28-36+6) weeks; 45 of them who presented with preterm uterine contractions were considered as the study group which was further subdivided into three subgroups according to gestational age 28–31+6 weeks, 32– 33+6 weeks, and 34–36+6 weeks. The other 45 pregnant women who presented to the hospital for regular antenatal care visit at comparable gestational age to the study group were considered as the control group. Hence, this study aimed to assess the serum level of P-LAP in both groups and compare it between those delivered preterm from term to assess its applicability as a predictor of preterm labor.
 Results: Serum level of P-LAP in pregnant women presented with TPL was found to be significantly lower in those delivered preterm (p<0.001), compared to those continued to term and control group especially in gestational ages ≥32 weeks, while the study found P-LAP level to be statistically insignificant in gestational age <32 weeks (p=0.052). The cutoff point for P-LAP serum level was = 21 (IU/ml) that below it, the pregnant women with TPL most probably deliver before 37 weeks of gestation with Sensitivity (85.7%) Specificity (90.3%), Positive predictive value (80.0%) Negative predictive (93.3%).
 Conclusion: The serum level of P-LAP was lower in women delivered preterm than those delivered at term, so it can be used as one of the markers for the prediction of preterm delivery, especially at gestational age >32 weeks.