Vitamin D-Binding Protein in Cervicovaginal Fluid as a Non-Invasive Predictor of Maternal and Fetal Outcome in Women with Preterm Labor

Abstract

Aim: This study aimed to determine whether vitamin D-binding protein (VDBP) in cervicovaginal fluid (CVF) is independently predictive of imminent spontaneous preterm delivery (SPTD, delivery within 48 hours) in women with preterm labor with intact membranes (PTL). Materials and Methods: This was a single-center observational cohort study. CVF samples for VDBP assays were obtained along with serum C-reactive protein (CRP) levels in consecutive women with PTL (n = 94) between 23.0 and 37.0 weeks of gestation. VDBP levels in CVF were determined by enzyme-linked immunosorbent assay kits. The primary outcome measures were SPTD within 48 hours after sampling. Results: In the multivariable analysis, elevated VDBP levels in CVF samples of PTL women were significantly associated with imminent preterm delivery, even after adjusting for potential confounders (e.g., gestational age at sampling, parity, and serum CRP). In women with PTL, the areas under receiver operating characteristic curves of CVF VDBP level for predicting imminent preterm delivery were 0.781, with cut-off values of 2.3 μg/mL (sensitivity of 63.16% and specificity of 96.0%), respectively. The CVF VDBP levels were significantly high in women with PTL. Conclusion: VDBP in the CVF independently predicts imminent preterm delivery in women with PTL.