Evaluation of trappin-2 in cervicovaginal secretions as predictor of spontaneous preterm birth in asymptomatic high-risk women: Nested case-control study.

Abstract

To evaluate trappin-2 levels in cervicovaginal secretions for prediction of spontaneous preterm birth (sPTB) and compare it with transvaginal sonography (TVS) cervical length in asymptomatic women at risk of PTB. Trappin-2 levels assessed in cervicovaginal secretions collected from 80 asymptomatic pregnant women at high risk for preterm delivery and cervical length measured by TVS, first at 14-20weeks of pregnancy and repeated 8weeks later. On the basis of delivery outcomes, participants were divided into cases (delivery <37weeks) and controls (delivery at 37-41weeks). The mean value of cervicovaginal trappin-2 was significantly higher in women who delivered preterm (n=40), compared with the term group (n=40: P<0.001) both at 14-20weeks and at 22-28weeks. The critical cut-off value for cervicovaginal trappin-2 at 14-20weeks was 4620pg/mL, above which participants delivered prematurely with sensitivity, specificity, and positive and negative predictive values of 82.5%, 71.0%, 78.5%, and 81.5% respectively, whereas TVS cervical length in this window period was not significantly associated with preterm birth. At 22-28weeks a trappin-2 value of 6900pg/mL had similar predictive accuracy. Raised cervicovaginal trappin-2 levels can be used as an early tool for prediction of PTB as early as 14-20weeks (earlier than TVS) in asymptomatic high-risk women.