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Objective  To identify serum protein markers in midtrimester that predict preterm delivery.    Methods  A retrospective case–control study randomly selected patients that experienced spontaneous preterm birth and healthy control patients that experienced a normal delivery at term. A proteomic analysis was undertaken using the data-independent acquisition method.    Results  A total of 30 singleton pregnant women were randomly selected from 12 800 pregnant women: 15 women had a spontaneous preterm birth (group Y) and 15 age- and body mass index-matched women gave birth at term (group D). All of the patients provided serum at 15–20 weeks of gestation. A total of 39 differentially expressed proteins were identified. Compared with group D, 24 proteins were upregulated and 15 were downregulated in the preterm group Y. Using Kyoto Encyclopedia of Genes and Genomes pathway enrichment, the 24 upregulated proteins were significantly enriched in the complement and coagulation cascade pathways. Search Tool for the Retrieval of Interacting Genes Furthermore (STRING) analysis showed that apolipoprotein A-II (apoA-II) and alpha-2-antiplasmin (α2-AP), two upregulated proteins, were key nodes in the STRING protein–protein network.    Conclusions  These findings suggest that apoA-II and α2-AP might be new markers for predicting preterm delivery in the midtrimester.

Serum apolipoprotein A-II and alpha-2-antiplasmin levels in midtrimester can be used as predictors of preterm delivery