المؤلفون: Erkamp, Jan S.^1,2 (AUTHOR), Voerman, Ellis^1,2 (AUTHOR), Steegers, Eric A. P.³ (AUTHOR), Mulders, Annemarie G. M. G. J.³ (AUTHOR), Reiss, Irwin K. M.^1,4 (AUTHOR), Duijts, Liesbeth^1,4,5 (AUTHOR), Jaddoe, Vincent W. V.^1,2 (AUTHOR), Gaillard, Romy^1,2 (AUTHOR) r.gaillard@erasmusmc.nl

المصدر: BMC Medicine. 4/7/2020, Vol. 18 Issue 1, p1-12. 12p. 2 Charts, 3 Graphs.

مصطلحات موضوعية: *PREMATURE labor, *FETAL ultrasonic imaging, *GESTATIONAL age, *VASCULAR resistance, *CHILDBIRTH, *ABRUPTIO placentae

مستخلص: Background: Preterm birth, small size for gestational age (SGA) and large size for gestational age (LGA) at birth are major risk factors for neonatal and long-term morbidity and mortality. It is unclear which periods of pregnancy are optimal for ultrasound screening to identify fetuses at risk of preterm birth, SGA or LGA at birth. We aimed to examine whether single or combined second and third trimester ultrasound in addition to maternal characteristics at the start of pregnancy are optimal to detect fetuses at risk for preterm birth, SGA and LGA.Methods: In a prospective population-based cohort among 7677 pregnant women, we measured second and third trimester estimated fetal weight (EFW), and uterine artery pulsatility and umbilical artery resistance indices as placenta flow measures. Screen positive was considered as EFW or placenta flow measure < 10th or > 90th percentile. Information about maternal age, body mass index, ethnicity, parity, smoking, fetal sex and birth outcomes was available from questionnaires and medical records. Screening performance was assessed via receiver operating characteristic (ROC) curves and area under the curve (AUC) along with sensitivity at different false-positive rates.Results: Maternal characteristics only and in combination with second trimester EFW had a moderate performance for screening for each adverse birth outcome. Screening performance improved by adding third trimester EFW to the maternal characteristics (AUCs for preterm birth 0.64 (95%CI 0.61 to 0.67); SGA 0.79 (95%CI 0.78 to 0.81); LGA 0.76 (95%CI 0.75; 0.78)). Adding third trimester placenta measures to this model improved only screening for risk of preterm birth (AUC 0.72 (95%CI 0.66 to 0.77) with sensitivity 37% at specificity 90%) and SGA (AUC 0.83 (95%CI 0.81 to 0.86) with sensitivity 55% at specificity 90%). Combining second and third trimester fetal and placental ultrasound did not lead to a better performance as compared to using only third trimester results.Conclusions: Combining single third trimester fetal and placental ultrasound results with maternal characteristics has the best screening performance for risks of preterm birth, SGA and LGA. As compared to second trimester screening, third trimester screening may double the detection of fetuses at risk of common adverse birth outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Pradhan, Dinesh¹ (AUTHOR) dinesh.bhutan@gmail.com, Nishizawa, Yoriko¹ (AUTHOR), Chhetri, Hari P² (AUTHOR)

المصدر: Journal of Tropical Pediatrics. Apr2020, Vol. 66 Issue 2, p163-170. 8p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *NEONATAL mortality, *CHILDBIRTH, *BIRTH rate, *PUBLIC hospitals, *CESAREAN section, *RESEARCH, *NEONATAL intensive care, *NEONATAL diseases, *RESEARCH methodology, *NEONATAL intensive care units, *FETAL growth retardation, *DISEASES, *EVALUATION research, *MEDICAL cooperation, *COMPARATIVE studies, *PREGNANCY complications, *MEDICAL referrals, *DISEASE prevalence, *INFANT mortality, *SMALL for gestational age

مصطلحات جغرافية: BHUTAN

مستخلص: Introduction: Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies.Aim: To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes.Methods: All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU).Results: Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high.Conclusion: This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan. [ABSTRACT FROM AUTHOR]

المؤلفون: Chiesa, Morgane¹ (AUTHOR), Ferrari, Diana C.¹ (AUTHOR) ferrari@neurochlore.fr, Ben-Ari, Yehezkel¹ (AUTHOR) ben-ari@neurochlore.fr

المصدر: Molecular Brain. 3/9/2020, Vol. 13 Issue 1, p1-8. 8p.

مصطلحات موضوعية: *PREMATURE labor, *CESAREAN section, *FETAL development, *MICE, *CHILDBIRTH

مستخلص: Delivery is a complex biological process involving hormonal and mechanical stimuli that together condition the survival and development of the fetus out of the womb. Accordingly, changes in the time or way of being born are associated with an alteration of fundamental biological functions and hypothesized to promote the emergence of neurodevelopmental disorders. Hence, the steadily rise in preterm birth and cesarean section (CS) delivery rates over the past years has become a worldwide health concern. In our previous work, we reported that even though no long-term autistic-like deficits were observed, mice born preterm by CS presented early transient neuronal and communicative defects. However, understanding if these alterations were due to an early birth combined with CS delivery, or if prematurity solely could lead to a similar outcome remained to be evaluated. Using mice born either at term or preterm by vaginal or CS delivery, we assessed early life ultrasonic vocalizations and the onset of eye opening. We report that alterations in communicative behaviors are finely attuned and specifically affected either by preterm birth or by the association between CS delivery and preterm birth in mice, while delayed onset of eye opening is due to prematurity. Moreover, our work further underlies a gender-dependent vulnerability to changes in the time and/or way of being born with distinct outcomes observed in males and females. Thus, our results shed light on the intricacy of birth alterations and might further explain the disparities reported in epidemiological studies. [ABSTRACT FROM AUTHOR]

المؤلفون: Wang, H.^1,2 (AUTHOR), Yue, H.¹ (AUTHOR) yuehongni@hotmail.com, Sun, B.³ (AUTHOR) bsun@shmu.edu.cn, Zhu, X.¹ (AUTHOR), Niu, H.¹ (AUTHOR), Qi, T.¹ (AUTHOR), Ding, W.¹ (AUTHOR), Han, L.¹ (AUTHOR), Zhang, M.⁴ (AUTHOR), Tian, Z.⁴ (AUTHOR), Guan, H.⁵ (AUTHOR), Yang, J.⁵ (AUTHOR), Li, S.⁶ (AUTHOR), Zhu, K.⁶ (AUTHOR), Tang, C.⁷ (AUTHOR), Dong, M.⁷ (AUTHOR), Yin, Y.² (AUTHOR), Cao, X.⁸ (AUTHOR), Zhang, J.⁸ (AUTHOR), Liu, H.⁹ (AUTHOR)

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Mar2020, Vol. 33 Issue 5, p838-846. 9p.

مصطلحات موضوعية: *NEONATAL mortality, *PREMATURE labor, *BIRTH rate, *DEMOGRAPHIC surveys, *CHILDBIRTH, *MULTIPLE birth, *PREMATURE infants, *INFANT mortality

مصطلحات جغرافية: JIANGSU Sheng (China), CHINA

مستخلص: Objective: This survey followed the birth population-based study conducted in 2010 in Huai'an, Jiangsu Province, with the aim to estimate perinatal-neonatal mortality and preterm birth rate in emerging regions with similar maternal-fetal and neonatal care conditions in China.Materials and methods: Data of total births in 2015 were prospectively collected by regional perinatal network collaboration in Huai'an, a subprovincial region with a population of 5,644,500 and gross domestic production of 9082 USD per capita.Results: The 59,424 birth registries (including 59,023 live births and 167 stillbirths) corresponded to a birth rate of 10.5‰ and a Male-to-female ratio of 113.7:100. All births there were from 85, 16, and 6 level I, II, and III hospitals, with a delivery rate of 30.4, 40.2, and 29.4%, respectively. Of all births, 14.1% had pregnancy-associated comorbidities and complications, 54.4% (32,226/59,190) had cesarean delivery, and multiple pregnancies and birth defects occurred in 2.1% (1,250) and 5.5‰ (324), respectively. The mean birth weight was 3448 ± 507 g with 13.9% being macrosomia, and 2.86% (1695/59,190) low birth weight. Preterm birth rate was 4.06% (2404/59,190) with a mortality rate of 8.5%. There were 94.5% recorded as healthy newborns and 5.5% (3263) requiring hospitalization after birth. The perinatal and neonatal mortality rate was 5.2‰ (167 stillbirths, 139 early neonatal deaths) and 4.0‰, respectively. Compared with the 2010 survey, these data demonstrated generally improved status of perinatal-neonatal healthcare.Conclusions: The low rates of perinatal-neonatal mortality, preterm birth and preterm mortality suggest that the concept and study protocol of perinatal-neonatal healthcare in Huai'an may serve as the benchmark for estimating regional vital statistics and perinatal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Kim, Yeonwoo^1,2 (AUTHOR), Vohra-Gupta, Shetal³ (AUTHOR), Margerison, Claire E.⁴ (AUTHOR), Cubbin, Catherine^3,5 (AUTHOR) ccubbin@austin.utexas.edu

المصدر: Journal of Urban Health. Feb2020, Vol. 97 Issue 1, p37-51. 15p. 4 Charts.

مصطلحات موضوعية: *PREMATURE labor, *BIRTH certificates, *NEIGHBORHOODS, *CHILDBIRTH, *HUMAN fertility, *NEIGHBORHOOD change

مصطلحات جغرافية: TEXAS

مستخلص: The black-white disparity in preterm birth has been well documented in the USA. The racial/ethnic composition of a neighborhood, as a marker of segregation, has been considered as an underlying cause of the racial difference in preterm birth. However, past literature using cross-sectional measures of neighborhood racial/ethnic composition has shown mixed results. Neighborhoods with static racial/ethnic compositions over time may have different social, political, economic, and service environments compared to neighborhoods undergoing changing racial/ethnic compositions, which may affect maternal health. We extend the past work by examining the contribution of neighborhood racial/ethnic composition trajectories over 20 years to the black-white difference in preterm birth. We used natality files (N = 477,652) from birth certificates for all live singleton births to non-Hispanic black and non-Hispanic white women in Texas from 2009 to 2011 linked to the Neighborhood Change Database. We measured neighborhood racial/ethnic trajectories over 20 years. Hierarchical generalized linear models examined relationships between neighborhood racial/ethnic trajectories and preterm birth, overall and by mother's race. Findings showed that overall, living in neighborhoods with a steady high proportion non-Hispanic black was associated with higher odds of preterm birth, compared with neighborhoods with a steady low proportion non-Hispanic black. Furthermore, while black women's odds of preterm birth was relatively unaffected by neighborhood proportions of the Latinx or non-Hispanic white population, white women had the highest odds of preterm birth in neighborhoods characterized by a steady high proportion Latinx or a steady low proportion non-Hispanic white. Black-white differences were the highest in neighborhoods characterized by a steady high proportion white. Findings suggest that white women are most protected from preterm birth when living in neighborhoods with a steady high concentration of whites or in neighborhoods with a steady low concentration of Latinxs, whereas black women experience high rates of preterm birth regardless of proportion white or Latinx. [ABSTRACT FROM AUTHOR]

المؤلفون: Yuan, Xiaosong¹ (AUTHOR), Gao, Yanfang² (AUTHOR) gyfg05@sina.com, Zhang, Ming² (AUTHOR), Long, Wei¹ (AUTHOR), Liu, Jianbing¹ (AUTHOR), Wang, Huiyan³ (AUTHOR), Yu, Bin¹ (AUTHOR) binyu@njmu.edu.cn, Xu, Jun¹ (AUTHOR) yyxujun@qq.com

المصدر: Clinica Chimica Acta. Feb2020, Vol. 501, p258-263. 6p.

مصطلحات موضوعية: *FETAL macrosomia, *PREMATURE labor, *FIBRIN fragment D, *PREGNANCY, *LOW birth weight, *CHILDBIRTH

مستخلص: • Plasma D-dimer levels in late pregnancy were positively associated with fetal growth indicators. • Increase in D-dimer quartiles were associated with an decreased risk for SGA, LBW and PTB infants. • Increase in D-dimer quartiles were associated with an increased risk for large for LGA and macrosomia infants. • D-dimer test in this study had risk evaluation value for obstetric outcomes. To investigate the association of D-dimer level during late pregnancy with birth outcomes in a Chinese population. A retrospective observational cohort study of 11,570 pregnant women who delivered in a single central hospital was conducted. Maternal plasma D-dimer levels at hospital admission and pregnancy outcomes were abstracted and analyzed from laboratory information system and hospital records, respectively. Maternal plasma D-dimer levels were associated with higher fetal growth indicators for the highest vs. lowest quartile (Q) of D-dimer (mean birth weight: 145.79 g, mean birth length: 0.11 cm, mean gestational age: 0.30 week). Increase in D-dimer quartiles were associated with an decreased risk for small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB) neonates, and with an increased risk for large for gestational age (LGA), and macrosomia infants (SGA: OR = 0.52, 95% CI: 0.43, 0.64; LBW: OR = 0.58, 95% CI: 0.38, 0.86; PTB: OR = 0.44, 95% CI: 0.35, 0.55; LGA: OR = 2.37, 95% CI: 2.01, 2.78; macrosomia: OR = 2.59, 95% CI, 2.06, 3.24; for Q4 vs. Q1). Maternal plasma D-dimer levels during late pregnancy were associated with birth outcomes and had risk evaluation value for these outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Crump, Casey^1,2 (AUTHOR) casey.crump@mssm.edu, Friberg, Danielle³ (AUTHOR), Li, Xinjun⁴ (AUTHOR), Sundquist, Jan^1,2,4 (AUTHOR), Sundquist, Kristina^1,2,4 (AUTHOR)

المصدر: International Journal of Epidemiology. Dec2019, Vol. 48 Issue 6, p2039-2049. 11p.

مصطلحات موضوعية: *PREMATURE labor, *SLEEP apnea syndromes, *CHILDBIRTH, *GESTATIONAL age, *NEUROBEHAVIORAL disorders, *COMPARATIVE studies, *PREMATURE infants, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *RESEARCH funding, *EVALUATION research, *PROPORTIONAL hazards models

مصطلحات جغرافية: SWEDEN

مستخلص: Background: Preterm birth (gestational age <37 weeks) has previously been associated with cardiometabolic and neuropsychiatric disorders into adulthood, but has seldom been examined in relation to sleep disorders. We conducted the first population-based study of preterm birth in relation to sleep-disordered breathing (SDB) from childhood into mid-adulthood.Methods: A national cohort study was conducted of all 4 186 615 singleton live births in Sweden during 1973-2014, who were followed for SDB ascertained from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth in relation to SDB while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed for potential confounding by unmeasured shared familial factors.Results: There were 171 100 (4.1%) persons diagnosed with SDB in 86.0 million person-years of follow-up. Preterm birth was associated with increased risk of SDB from childhood into mid-adulthood, relative to full-term birth (39-41 weeks) [adjusted hazard ratio (aHR), ages 0-43 years: 1.43; 95% confidence interval (CI), 1.40, 1.46; P <0.001; ages 30-43 years: 1.40; 95% CI, 1.34, 1.47; P <0.001]. Persons born extremely preterm (<28 weeks) had more than 2-fold risks (aHR, ages 0-43 years: 2.63; 95% CI, 2.41, 2.87; P <0.001; ages 30-43 years: 2.22; 95% CI, 1.64, 3.01; P <0.001). These associations affected both males and females, but accounted for more SDB cases among males (additive interaction, P = 0.003). Co-sibling analyses suggested that these findings were only partly due to shared genetic or environmental factors in families.Conclusions: Preterm-born children and adults need long-term follow-up for anticipatory screening and potential treatment of SDB. [ABSTRACT FROM AUTHOR]

المؤلفون: Casteleiro, Ana¹ (AUTHOR), Paz-Zulueta, María^2,3 (AUTHOR) maria.paz@unican.es, Parás-Bravo, Paula^2,4 (AUTHOR), Ruiz-Azcona, Laura² (AUTHOR), Santibañez, Miguel^2,4 (AUTHOR)

المصدر: PLoS ONE. 11/26/2019, Vol. 14 Issue 11, p1-13. 13p.

مصطلحات موضوعية: *MATERNAL age, *PREMATURE labor, *CROSS-sectional method, *AGE groups, *GESTATIONAL diabetes, *PREGNANT women, *CHILDBIRTH

مستخلص: Background and objective: Over recent decades, a progressive increase in the maternal age at childbirth has been observed in developed countries, posing a health risk for both women and infants. The aim of this study was to analyze the association between advanced maternal age (AMA) and maternal and neonatal morbidity. Material and methods: A cross-sectional study of 3,315 births was conducted in the north of Spain in 2014. We compared childbirth between women aged 35 years or older, with a reference group of women aged between 24 and 27 years. AMA was categorized based on ordinal ranking into 35–38 years, 39–42 years, and >42 years to estimate a dose-response pattern (the older the age, the greater the risk). As an association measure, crude and adjusted Odds Ratios (OR) were estimated by non-conditional logistic regression and 95% Confidence Intervals (95%CI) were calculated. Results: Repeated abortions were more common among women of AMA in comparison to pregnant women aged 24–27 years (reference group): adjusted OR = 2.68; 95%CI (1.52–4.73). A higher prevalence of gestational diabetes was also observed among women of AMA, reaching statistical significance when restricted to first time mothers: adjusted OR = 8.55; 95%CI (1.12–65.43). In addition, the possibility of an instrumental delivery was multiplied by 1.6 and the possibility of a cesarean by 1.5 among women of AMA, with these results reaching statistical significance, and observing a dose-response pattern. Lastly, there were associations between preeclampsia, preterm birth (<37 weeks) and low birthweight, however without reaching statistical significance. Conclusion: Our results support the association between AMA and suffering repeated abortions. Likewise, being of AMA was associated with a greater risk of suffering from gestational diabetes, especially among primiparous women, as well as being associated with both instrumental deliveries and cesareans among both primiparous and multiparous women. [ABSTRACT FROM AUTHOR]

المؤلفون: Woday, Abay¹ (AUTHOR), Muluneh, Muluken Dessalegn^2,3 (AUTHOR) destamule@gmail.com, Sherif, Samiha⁴ (AUTHOR)

المصدر: PLoS ONE. 11/11/2019, Vol. 14 Issue 11, p1-12. 12p.

مصطلحات موضوعية: *PREMATURE labor, *MOTHERS, *PRENATAL care, *PUBLIC hospitals, *CHILDBIRTH, *CHILDBIRTH at home

مصطلحات جغرافية: ETHIOPIA

مستخلص: Background: Preterm birth (PTB) is a public health issue worldwide. In developing nations, like Ethiopia, PTB is under reported and underestimated. However, it is the leading cause of neonatal and under-five mortality in Ethiopia. Besides, limited and non-comparative research studies to date has been conducted in the country to address the prevalence of PTB. Therefore, this study aims to determine predictors of PTB. Methods: Hospital-based unmatched case control study was employed on a sample of 139 cases and 278 controls from October 2017 to December 2017 in the Amhara region, Ethiopia. The cases and controls were proportionally allocated in each hospital based on the last one-year case flows. As soon as a case was identified, the respective two controls were enrolled until the required sample size was satisfied. The outcome variable was measured by using either last menstrual period (LMP), early ultrasound result, or Ballard maturity examination. Face-to-face interviews were conducted using a standardized, structured, and pre-tested questionnaire to collect data. The collected data was entered into Epi-data and exported into SPSS for analysis. Independent variables with p-values < 0.25 in the bivariate analysis were entered into multivariable logistic regression models with forward logistic regressions method to control the influence of covariates. Ethical clearance was ensured. Results: A total of 134 cases and 268 controls participated with a response rate of 96.4%. After adjusting for covariates, the following variables were associated with PTB: residing in rural areas [AOR = 2.99: 95% CI 1.19, 7.48], low maternal age [AOR = 3.47: 95% CI 1.11, 10.83], being illiterate [AOR = 4.56: 95% CI 1.11,8.62], short birth spacing [AOR = 2.48: 95% CI 1.07, 5.75], no antenatal care visits for this index pregnancy [AOR = 10.78: 95% CI 4.43, 26.25], having a history of previous adverse birth outcomes [AOR = 3.47: 95% CI 1.51, 8.02], and exposure to medical problems during pregnancy [AOR = 13.94: 95% CI 4.39, 24.27]. Conclusion: The study revealed maternal sociodemographic factors, short birth space, lack of antenatal care, exposure to previous adverse birth outcomes and facing medical illnesses during pregnancy were the predictors of PTB. Therefore, inclusive preventive and control interventions should be developed at regional, zonal and district levels to reduce the burden of PTB among women resided in rural areas such as integrating antenatal care services into the existing health extension packages. Study results suggest increasing the awareness of PTB, contraceptive utilization and counseling to enhance birth spacing, antenatal care visits, and accessibility to services among women in Ethiopia should be given due attention. Health care providers should focus on mothers with previous adverse birth outcomes and those exposed to medical problems during pregnancy. Additional community based longitudinal studies supplemented with qualitative methods are recommended. [ABSTRACT FROM AUTHOR]

المؤلفون: Ronzoni, Stefania¹ (AUTHOR) stefania.ronzoni@sunnybrook.ca, D'Souza, Rohan² (AUTHOR), Shynlova, Oksana³ (AUTHOR), Lye, Stephen³ (AUTHOR), Murphy, Kellie E.² (AUTHOR)

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Oct2019, Vol. 32 Issue 20, p3473-3479. 7p.

مصطلحات موضوعية: *PREMATURE labor, *PREGNANCY, *PREMATURE rupture of fetal membranes, *GESTATIONAL age, *CHILDBIRTH

مستخلص: Objective: To compare maternal blood endotoxin activity (EA) in women with preterm premature rupture of membranes (PPROM) with gestational age (GA) matched controls; to evaluate serial EA till birth in PPROM and its correlation with latency to delivery. Methods: We followed singleton preterm pregnancies from admission with PPROM until birth. Uncomplicated, GA-matched pregnancies served as controls. Demographics, birth and neonatal outcomes were collected. EA (EAA™) was assessed serially in PPROM and at study entry in controls. EA was compared using Mann Whitney and Wilcoxon tests, p value <.05 was considered significant. Results: We recruited 20 cases of PPROM and 20 controls. Demographics were similar between groups. Mean GA of PPROM was 29.0 ± 2.2 weeks and median latency was 7.5 (IQR 14.1) weeks. Median EA at admission following PPROM was significantly elevated over controls (0.43 (0.18) versus 0.36 (0.2); p <.02). Overall there was no difference in median EA at admission and in labor (0.43 (0.18) versus 0.33 (0.21); p =.2) following PPROM. However, on comparing cases with latency to delivery ≤7 days (n = 10) versus >7 days (n = 10), there was a significant drop in EA in the latter group (0.44 (0.2) versus 0.34 (0.2); p <.004). Conclusions: EA in PPROM represents a promising biomarker in predicting the clinical evolution of preterm birth. [ABSTRACT FROM AUTHOR]