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DOI: 10.18413/2658-6533-2021-7-4-0-8

Multifactoriality of causes of preterm birth

Background: The high prevalence of preterm births is a serious clinical problem with significant socio-economic and medical consequences, challenging obstetricians and gynecologists to find new predictors for them. The aim of the study: Toidentify significant markers of preterm labor and evaluate the possibility of using them to create a mathematical model for predicting preterm birth. Materials and methods: The prospective comparative study included 85 pregnant women who formed two groups: group 1 (n=42) who gave birth prematurely and group 2 (n=43) who carried their babies to term. In both groups, somatic and reproductive history was examined, age and body mass index were assessed. The levels of hemoglobin, leukocyte and neutrophils count, as well as concentration of ferritin, IL-6, and relaxin were determined in all patients. Results: In age-homogeneous groups (р=0.476), the body mass indexes in groups 1 and 2 were 25.08±2.96 and 23.0±1.88, respectively (р=0.001); the menarche's age in the group 1 and 2 was 11.45±0.99yy and 12.28±1.20yy, respectively (р=0.003); the duration of menstruation in the group 1 (4.00±0.77dd) was less than in group 2 (4.81±1.37dd) (p=0.008). Gastrointestinal diseases in group 1 and group 2 were recorded in 61.9% and 30.23% of women, respectively (p=0.003). Various endocrinopathies in group 1 and group 2 were recorded in 38.1% and 16.28% of women, respectively (p=0.024). The frequency of urinary tract infection in group 1 and group 2 was 54.76% and 25.58%, respectively (p=0.006). Hemoglobin levels in women with preterm birth (114.12±12.22 g/l) were lower than in women who carried their babies to term (121.95±10.36 g/l) (p=0.002); the count of RBC in the 1st and 2nd group was 3.73±0.38 1012/l and 3.94±0.41 1012/l, respectively (p=0.018). The levels of ferritin in the 1st and 2nd group were 21.81±9.69 µg/l and 78.84±17.86 µg/l, respectively (р=0.001). The levels of IL-6 in the 1st and 2nd group were 124.78±10.88 pg/ml and 80.96±5.07 pg/ml, respectively (р=0.001); the count of WBC in the 1st and 2nd group was 14.4±4.66 109/l and 11.97±2.38 109/l, respectively (р=0.021), and neutrophils in the 1st and 2nd group were 81.46±7.85% and 72.24±7.16%, respectively (р=0.002). Moderate Spearman’s rank correlation between prolactin and relaxin in the 1st (R=0.515) and 2nd (R=0.454) group has been established. The identified risk factors were used to create a predictive mathematical model by reference vectors and automatic neural networks. Conclusion: The age menarche, duration of menstruation, gastrointestinal diseases, urogenital infections, and endocrine disorders, as well as neutrophils levels, WBC, IL-6, ferritin, prolactin, and relaxin levels correlate with the risk of preterm birth.

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