Placental protein 14 as a potential biomarker for diagnosis of preterm prelabor rupture of membranes

<p style="text-align: justify;"><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">Preterm prelabor rupture of membranes (PPROM) is a major cause of neonatal morbidity and mortality. Placental Protein 14 (PP14), a glycodelin glycoprotein, has emerged as a potential biomarker for the diagnosis of PPROM. The study aimed to evaluate the diagnostic accuracy of PP14 in detecting fetal membrane rupture. This case-control study was conducted at Al Yarmouk Teaching Hospital from January to October 2023. The sample included 45 pregnant women diagnosed with PPROM who were compared to 45 pregnant women with intact membranes. Vaginal fluid samples collected from women in both groups were tested with nitrazine paper and then sent to the laboratory for PP14c measurement using immunoassay. PPROM cases had significantly higher vaginal PP14 levels than controls (mean 0.0108 ± 0.002 ng/mL vs. 0.0056 ± 0.003 ng/mL; p < 0.001). ROC analysis showed an AUC of 0.852 (95% CI: 0.762–0.941; p < 0.001). Using a cut-off of 0.0078 ng/mL, PP14 yielded a sensitivity of 97.8% and specificity of 77.8%. The odds of elevated PP14 (≥ 0.0078 ng/mL) were significantly higher in PPROM cases (OR = 154; 95% CI: 18.8–1261.4; p < 0.001). In conclusion, vaginal PP14 demonstrates strong diagnostic performance for PPROM, combining high sensitivity with good specificity. PP14 is a promising, low-cost potential adjunct to conventional bedside tests and could improve early, accurate detection of membrane rupture, facilitating timely clinical management.</span></p>