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  • Mid-Trimester Blood...

Mid-Trimester Blood Test and Treatment Bundle may Reduce Preterm Birth Risks: Study

Dr. Shravani DaliWritten by Dr. Shravani Dali Published On 2025-02-20T20:30:05+05:30  |  Updated On 20 Feb 2025 8:30 PM IST
Mid-Trimester Blood Test and Treatment Bundle may Reduce Preterm Birth Risks: Study
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According to a new research mid-trimester blood test successfully identified average-risk women at risk for preterm birth. Researchers found that a treatment bundle, including progesterone and low-dose aspirin, significantly reduced neonatal morbidity and hospital stay compared to usual care. Presented at The Pregnancy Meeting, the study showed that when paired with a three-step treatment bundle, the predictive blood test markedly improved neonatal outcomes.

Obstetric advances have had limited impact on preterm birth (PTB) rates and neonatal outcomes. We assessed outcomes in a cohort of average risk singleton pregnancies using biomarker-based PTB risk stratification, followed by interventions for those identified at higher risk. This randomized controlled trial enrolled 5,018 singleton pregnancies at 19 U.S. centers from 2020-2023. Individuals with prior PTB, short cervix, severe maternal conditions, or known genetic/fetal anomalies were excluded. We measured the ratio of maternal circulating insulin-like growth factor-binding protein 4 to sex hormone-binding globulin between 18w0d and 20w6d, with participants randomized 1:1. The control arm, blinded to test results, received usual care, while the prevention arm received test results. Prevention arm participants identified as high-risk were offered a regimen of daily vaginal progesterone, low-dose aspirin, and weekly nursing calls. Lower-risk participants in the prevention arm received usual care. Follow-up continued through delivery and neonatal discharge. The prespecified modified intent-to-treat (mITT) analysis included the control group, prevention arm low-risk participants, and high-risk participants who consented to intervention by 24 weeks, while excluding those hospitalized with COVID-19. Primary outcomes included neonatal length of stay (NNLOS) and a composite morbidity index (NMI). A planned intent-to-treat (ITT) analysis assessed multiple neonatal outcomes. Results: Baseline characteristics did not differ between arms. mITT analysis of co-primary outcomes (Table 1) showed significantly decreased NMI and NNLOS in the prevention arm. The ITT analysis displayed significant reductions in NMI (20%), NNLOS (8%), neonatal intensive care unit (NICU) length of stay (6%), and NICU admission (20%). In an average risk singleton population, a mid-trimester blood test identified pregnancies at higher PTB risk, and implementing the treatment bundle significantly reduced neonatal morbidity and hospital stay compared to usual care.


Reference:

Iriye, B. K., O'Brien, J., Ennen, C. S., Barrilleaux, P., Berkin, J., Palatnik, A., Son, M., Gyamfi-Bannerman, C., McDonald, M., Markenson, G., Sciscione, A. C., Biggio, J. R., Wolf, S., Sullivan, S., Walker, M., Shahbaba, B., & Pound, S. P. (2025, January 31). Neonatal impact of prematurity risk biomarker screening with targeted interventions: A multicenter randomized controlled trial [Conference presentation]. Aurora Ballroom, Lobby Level, Hera Women's Health, Las Vegas, NV, United States.


Keywords:

Mid-Trimester, Blood Test, Treatment, Bundle, Reduce, Preterm, Birth Risks, Iriye, B. K., O'Brien, J., Ennen, C. S., Barrilleaux, P., Berkin, J., Palatnik, A., Son, M., Gyamfi-Bannerman, C., McDonald, M., Markenson, G., Sciscione, A. C., Biggio, J. R., Wolf, S., Sullivan, S., Walker, M., Shahbaba, B., & Pound, S. P.



Mid-TrimesterBlood TestTreatmentBundleReducePretermBirth Risks
Source : SMFM 2025 Pregnancy Meeting
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

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