In a prospective cohort study, low maternal serum CC-chemokine-ligand 2 (CCL2) levels correlated with an increased risk of preterm birth within 7 days in high-risk pregnant women. Elevated CXC-chemokine-ligand 10 (CXCL10) serum levels were more indicative of a heightened risk for preterm birth before 34 weeks. The heightened CXCL10/CCL2 ratio demonstrated the most reliable predictive performance.

Researchers sought to assess whether chemokines like CCL2 and CXCL10 could predict the risk of spontaneous preterm birth in a cohort of symptomatic high-risk pregnant women. Overall, 109 females exhibiting preterm labor signs between 20 + 0 and 31 + 6 weeks of pregnancy were recruited in the study. The inclusion criteria encompassed a history of previous preterm birth, cervical length less than 25 mm, or painful contractions or regular contractions (less than 3 in 30 minutes).

Blood samples were collected upon the initial admission, and biomarker concentrations were determined utilizing pre-coated sandwich immunoassays (enzyme-linked immunosorbent assay [ELISA]). The major endpoint of the study was spontaneous preterm birth before 34 weeks, while the secondary endpoint was delivery before 37 weeks or within 7 days following study inclusion. A total of 16 women (14.7%), delivered before 34 weeks, while twenty women (18.4%), gave birth between 34 + 0 and 36 + 6 weeks.

Additionally, 6 subjects (5.5%) delivered within 7 days following study admission. Women experiencing preterm birth before 34 weeks exhibited higher medium serum levels of CXCL10 (115 pg/ml) compared to those delivering at or beyond 34 weeks (61 pg/ml). Similarly, CXCL10 levels were higher in women delivering before 37 weeks (103 pg/ml vs. 53 pg/ml). In contrast, reduced levels of CCL2 in maternal serum were linked with delivery within seven days (25 pg/ml vs. 73 pg/ml) and preterm birth before 34 weeks (46 pg/ml vs. 73 pg/ml).

The CXCL10/CCL2 ratio enhanced the predictive model, yielding an area under the receiver operating characteristic curve (ROC-AUC) of 0.83 for delivery before 34 weeks, corresponding to positive predictive value, specificity, and sensitivity of 0.43, 0.86, and 0.67, respectively, at a cut-off of 2.2. Both chemokines were favorable in the longer-term prediction of preterm birth.