{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:12:23Z","timestamp":1790082743430,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["2023ZD0517600"],"award-info":[{"award-number":["2023ZD0517600"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study investigates maternal serum occludin and human leukocyte antigen G (HLA\u2010G) profiles across preterm birth subtypes and their predictive value for neonatal respiratory distress syndrome (NRDS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective analysis was conducted at Tianjin Central Hospital of Gynecology Obstetrics in Tianjin, China. The study utilized a prospectively collected cohort of 133 singleton preterm births, including iatrogenic preterm birth (iPB,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922), spontaneous preterm labor with intact membranes (sPTL,\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u200961), and preterm premature rupture of membranes (pPROM,\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u200950). Maternal serum levels of occludin and HLA\u2010G were measured via ELISA assays. Subtype\u2010specific predictive performance for NRDS was assessed using receiver operating characteristic curve analysis based on logistic regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Maternal serum occludin concentrations exhibited distinct subtype\u2010specific distributions: the highest levels in the iPB group, intermediate levels in the pPROM group, and lowest levels in the sPTL group (overall\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), which remained significant after adjusting for gestational age at delivery. HLA\u2010G levels were markedly lower in the pPROM and sPTL groups compared to the iPB group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Notably, within the sPTL cohort, pregnancies complicated by NRDS exhibited not only a reduced gestational age (\n                      <jats:italic>P\u2009&lt;<\/jats:italic>\n                      \u20090.001) but also a paradoxical elevation in maternal occludin levels (\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.019). A combined model incorporating occludin and gestational age at delivery demonstrated excellent discriminatory power for predicting NRDS specifically within the sPTL subtype (area under the curve\u2009=\u20090.829, 95% confidence interval: 0.714\u20130.943).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preterm birth subtypes manifest substantial pathophysiological heterogeneity along the \u201cbarrier\u2010immune\u201d axis. Specifically in sPTL, the combination of maternal occludin levels with gestational age might serve as a potential noninvasive adjunctive biomarker for NRDS risk stratification, although its predictive value requires further validation in larger prospective cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71319","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:32:05Z","timestamp":1790080325000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive value of maternal serum occludin for neonatal respiratory distress syndrome in spontaneous preterm birth"],"prefix":"10.1002","author":[{"given":"Qimei","family":"Lin","sequence":"first","affiliation":[{"name":"Tianjin Institute of Gynecology Obstetrics Tianjin Central Hospital of Gynecology Obstetrics  Tianjin China"},{"name":"Tianjin Key Laboratory of Human Development and Reproductive Regulation Tianjin Central Hospital of Gynecology Obstetrics  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiasong","family":"Cao","sequence":"additional","affiliation":[{"name":"Tianjin Institute of Gynecology Obstetrics Tianjin Central Hospital of Gynecology Obstetrics  Tianjin China"},{"name":"Tianjin Key Laboratory of Human Development and Reproductive Regulation Tianjin Central Hospital of Gynecology Obstetrics  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taihua","family":"He","sequence":"additional","affiliation":[{"name":"School of Stomatology Harbin Medical University  Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Li","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine Tianjin Medical University  Tianjin 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