Noninvasive assessment of classic and high PPROM using cervicovaginal podocalyxin and nephrin: Findings from a prospective observational study

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dc.contributor.authorKali, Zercan
dc.contributor.authorKarli, Pervin
dc.contributor.authorKarabulut, Umran
dc.contributor.authorCagiran, Fatma Tanilir
dc.contributor.authorKirici, Pinar
dc.contributor.authorEge, Serhat
dc.date.accessioned2026-04-04T13:33:25Z
dc.date.available2026-04-04T13:33:25Z
dc.date.issued2025
dc.departmentİnönü Üniversitesi
dc.description.abstractThis study assesses the diagnostic and prognostic value of cervicovaginal amniotic fluid (CVAF) podocalyxin (PDX) and nephrin levels in pregnancies with classic and high preterm premature rupture of membranes (PPROM), focusing on neonatal outcomes. This prospective study included 144 singleton pregnancies between 22 and 34 weeks, classified as classic PPROM (n = 74), high PPROM (n = 32), and controls (n = 38). CVAF and serum samples were analyzed using enzyme-linked immunosorbent assay to quantify PDX and nephrin levels. Receiver operating characteristic curves evaluated diagnostic performance. Logistic regression identified predictors of respiratory distress syndrome and bronchopulmonary dysplasia. CVAF PDX and nephrin levels were significantly higher in the classic PPROM group (35.05 +/- 5.55 and 12.88 +/- 3.85 ng/mL, respectively) compared to high PPROM and control groups. Receiver operating characteristic analysis demonstrated excellent diagnostic performance for distinguishing classic PPROM, with area under the curve values of 0.92 (95% confidence interval [CI]: 0.88-0.96) for PDX and 0.93 (95% CI: 0.89-0.97) for nephrin. In multivariable logistic regression, elevated PDX was independently associated with bronchopulmonary dysplasia (odds ratio = 1.32, 95% CI: 1.10-1.59), while elevated nephrin predicted respiratory distress syndrome (odds ratio = 1.18, 95% CI: 1.02-1.36). These findings support their utility as noninvasive biomarkers for both diagnosis and risk stratification in PPROM. CVAF PDX and nephrin demonstrated significant diagnostic and prognostic value in differentiating PPROM subtypes and may be useful for neonatal risk stratification. These findings suggest that CVAF PDX and nephrin levels may serve as noninvasive tools for early identification of high-risk PPROM cases, potentially guiding timely intervention and targeted neonatal care.
dc.identifier.doi10.1097/MD.0000000000045383
dc.identifier.issn0025-7974
dc.identifier.issn1536-5964
dc.identifier.issue43
dc.identifier.pmid41137277
dc.identifier.urihttps://doi.org/10.1097/MD.0000000000045383
dc.identifier.urihttps://hdl.handle.net/11616/109155
dc.identifier.volume104
dc.identifier.wosWOS:001600700800039
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofMedicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectbronchopulmonary dysplasia
dc.subjectfetal membranes
dc.subjectnephrin
dc.subjectpodocalyxin
dc.subjectpremature
dc.subjectrespiratory distress syndrome
dc.subjectROC curve
dc.subjectrupture
dc.titleNoninvasive assessment of classic and high PPROM using cervicovaginal podocalyxin and nephrin: Findings from a prospective observational study
dc.typeArticle

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