The significance of lipocalin-2, an inflammatory and immune marker in preterm labor


Aliyeva G., Akar A. N., Çirkin Tekeş G., Ağaoğlu R. T., Öztürk Ö., Sümer D., ...Daha Fazla

Irish Journal of Medical Science, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1007/s11845-026-04534-5
  • Dergi Adı: Irish Journal of Medical Science
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: Lipocalin-2, Preterm labor, Preterm birth, Inflammation, Neonatal outcomes, Composite adverse perinatal outcomes
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Background: Inflammation is central to the pathogenesis of preterm labor (PTL), yet evidence on maternal serum lipocalin-2 (LCN-2) in PTL remains limited. Aim: To investigate the significance of LCN-2, an inflammatory and immune marker, in PTL and its relationship with composite adverse perinatal outcomes (CAPOs). Methods: This prospective study was conducted at a tertiary perinatology clinic from June to December 2025. We enrolled 90 pregnant women at 28–37 weeks (45 with PTL, 45 controls; matched 1:1). Maternal serum LCN-2 was measured by ELISA. The PTL group was stratified into early (< 34 weeks) and late (34 + 0–36 + 6 weeks) subgroups and by CAPOs. Maternal and neonatal data were compared, and LCN-2’s diagnostic performance was assessed. Multivariable logistic regression assessed its independent association with PTL and CAPO after confounder adjustment. Results: LCN-2 was higher in the PTL group than in controls (162.24 ± 53.16 vs. 131.20 ± 29.68 pg/mL; p = 0.001), with no difference between early and late subgroups (p > 0.05). It correlated weakly with neonatal intensive care unit stay (r = 0.287, p = 0.046). On ROC analysis, LCN-2 modestly discriminated PTL (AUC 0.658; 95% CI 0.550–0.754; p = 0.007; sensitivity 68.9%, specificity 60.0%; cutoff > 128.95 pg/mL). After adjustment for maternal age, gestational age at sampling, and pre-pregnancy BMI, LCN-2 remained independently associated with PTL (aOR 1.019; 95% CI 1.007–1.032; p = 0.002) but not with CAPO within the PTL group (p = 0.142). Conclusions: Elevated maternal LCN-2 in PTL reflects involvement in inflammatory processes underlying preterm birth; however, its limited diagnostic accuracy and weak association with neonatal outcomes suggest it mainly indicates disease activity.