Usefulness of trappin-2 level in cervicovaginal secretion in predicting spontaneous preterm birth in asymptomatic high-risk women: A prospective case–control study at a tertiary care centre.

Pintu  Satyarthi; Shaila   Mitra; Ankita  Kumari; Afifa   Aftab; Sunita   Bharti; Alpana   Bundela; Archana   Bundela

doi:10.51168/sjhrafrica.v6i12.2269

Authors

Pintu Satyarthi Resident, Department of Pathology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
Shaila Mitra Professor, Department of Pathology, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
Ankita Kumari Associate Professor, Department of Obstetrics and Gynaecology, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
Afifa Aftab Assistant Professor, Department of Community Medicine, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
Sunita Bharti Assistant Professor, Department of Pathology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
Alpana Bundela Assistant Professor, Department of Pathology, BRD Medical College, Gorakhpur, Uttar Pradesh, India
Archana Bundela Assistant Professor, Department of Pathology, BRD Medical College, Gorakhpur, Uttar Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2269

Keywords:

Trappin-2, Cervicovaginal fluid, Spontaneous preterm birth, Biomarker, Predictive accuracy, High-risk pregnancy, enzyme-linked immunosorbent assay

Abstract

Background:

Spontaneous preterm birth (SPTB) remains a major contributor to neonatal morbidity and mortality, especially in developing countries. Identifying reliable early biomarkers in asymptomatic high-risk women could improve risk stratification and perinatal outcomes. Trappin-2, an antiprotease and innate immune modulator, plays a critical role in mucosal defense and inflammation within the cervicovaginal environment.

Objectives:

To assess cervicovaginal fluid (CVF) Trappin-2 levels in predicting spontaneous preterm birth in asymptomatic high-risk pregnant women and across two mid-trimester sampling windows.

Methods:

This prospective case–control study included 100 pregnant women (50 preterm and 50 term) enrolled between 14 and 20 weeks of gestation and followed through delivery. Cervicovaginal secretions were collected twice, at 14–20 and 22–28 weeks, respectively, using sterile dacron swabs. Trappin-2 concentrations were quantified using an ELISA assay, and the sensitivity, specificity, and predictive value were evaluated.

Results:

The majority of participants were aged 20–30 years (66%), and 70% had regular antenatal care visits. Mean CVF Trappin‑2 levels were significantly higher in women who delivered preterm compared with term controls at both visits (14–20 weeks: 6124 ± 1102 pg/ml vs 3100 ± 1529 pg/ml; 22–28 weeks: 7915 ± 2112 pg/ml vs 4100 ± 1602 pg/ml; p < 0.001). Sensitivity and specificity at the second visit were 76.4% and 66.2%, respectively, with a high negative predictive value (>90%).

Conclusion:

Cervicovaginal Trappin-2 can be used as a promising early biomarker for identifying women at risk of spontaneous preterm birth. Its reproducible mid-trimester elevation and high negative predictive value support its integration into antenatal screening to guide timely interventions and improve neonatal outcomes.

Recommendation:

Routine mid-trimester screening of cervicovaginal Trappin-2 levels in asymptomatic high-risk pregnant women is recommended to aid early risk stratification. Integration of this biomarker into antenatal care may facilitate timely preventive interventions and improve perinatal outcomes.

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