Prediction of preterm delivery using plasma corticotrophin-releasing hormone and other biochemical variables.

Preterm delivery is responsible for the vast majority of neonatal mortality in developed countries and is also associated with substantial long-term morbidity. The incidence of preterm birth remains between 6-10% despite many advances in our understanding of the physiology of human parturition. Biochemical markers have been used in an attempt to identify more accurately those women, amongst high and low-risk groups who will deliver preterm, from their counterparts who will go on to deliver at term. Only by accurately identifying those women early, who will eventually deliver preterm, will specific interventions be able to be used in order to try and treat the cause or delay delivery until a safer time for the fetus. The clinical utility of these markers when used alone in an unselected population remains limited. As our understanding of the pathophysiology of preterm delivery improves, the challenge lies for researchers to combine these markers in the most effective way to unravel the complex biological system of parturition and improve the predictive capability of a biochemical test for prematurity.