Prematurity (birth before 37 weeks of amenorrhea) is the leading cause of death and perinatal morbidities / disabilities in children under five. In half of the cases, a premature birth is preceded by symptoms of preterm labor, including cervical changes and painful uterine contractions, and is the main cause of hospitalization during pregnancy (5.4% of pregnancies in France = 45,000 cases / year). However almost 75% of them will give birth at term. To date, no reliable test to assess risk of imminent delivery is available for the clinical practice, or is insufficiently precise. The new biomarkers discovered and proposed here, based on the latest advances in parturition research, emphasize specific steps of a dialogue between stromal and immune cells in the early stages of labor. They rely on secretion of proteins involved in matrix remodeling and by the activation of immunity, both being determined from a sample of vaginal secretions. Validated in two dedicated cohorts totalizing hundreds of women, these new biomarkers revealed their abilities for predicting the risk of childbirth within 24 hours, 7 days or 14 days with higher sensitivity / specificity scores compared to existing tests & markers. Current ongoing work aims to define a specific combination of those ones for set-up a first rapid, sensitive & precise test in “point-of-care” childbirth.
Childbirth - Prematurity - Preterm delivery - Biomakers - Cervicovaginal fluid