Significance of antimicrobial peptide expression and vitamin 25(OH)D content as prognostic markers of perinatal loss in preterm premature rupture of membranes before 36 weeks of gestation




perinatal outcomes, stillbirth, preterm premature rupture of membranes, vitamin 25(OH)D, β-defensins 2 expression, prognostic model


Purpose - to estimate the prognostic value of vitamin 25(OH)D levels and the expression of antimicrobial peptides (β-defensins 2) in maternal blood in predicting perinatal losses in preterm premature rupture of membranes (pPROM) up to 36 weeks of gestation.

Materials and methods. A total of 109 women with singleton pregnancies complicated by pPROM at 23 to 36 weeks’ gestation and 20 women in the control group with intact membranes who subsequently gave birth to full-term infants were prospectively screened. A standard examination of pregnant women with pPROM was performed, and vitamin 25(OH)D levels and β-defensin 2 expression were examined by enzyme-linked immunoassay.

Results. Correlation analysis revealed significant associations between the incidence of perinatal loss in preterm pregnancy complicated by pPROM, both with gestational age and maternal factors such as moderate anemia, serum vitamin 25(OH)D and β-defensins 2 expression, low coverage of preventive measures for neonatal respiratory distress syndrome.

Conclusions. On the basis of the selected predictors, 3 multivariate logistic regression models were built, which allow to estimate the probability of perinatal losses in preterm pregnancy complicated by pPROM at the individual level with fairly high diagnostic efficiency - sensitivity (62.5-75.0%), specificity (100%), accuracy of the forecast (97.3-98.2%).

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interest was declared by the authors.


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