Physiological and Hormonal Predictors of Preterm Labour in Primigravidae Attending Antenatal Care in Gombe State, North East Nigeria

Background: Preterm birth remains a leading cause of neonatal mortality in Nigeria, with rates highest in the North East geopolitical zone. The physiological mechanisms triggering preterm labour include premature activation of the foetal-placental endocrine axis, progesterone withdrawal, and uterine inflammatory signalling. Analytical studies identifying early hormonal and physiological predictors of preterm labour in Nigerian primigravidae are scarce. Objectives: This study aims to identify physiological and hormonal predictors of preterm labour, including cervical length by transvaginal ultrasound, serum progesterone, oestriol, corticotrophin-releasing hormone, and interleukin-8, measured at 18 to 22 weeks of gestation in primigravidae attending the Federal Teaching Hospital Gombe. Methods: Eighty primigravidae will be recruited and followed until delivery. Hormonal parameters will be assayed at the index visit. Cervical length will be measured by transvaginal ultrasound. Preterm delivery before 37 weeks will be the primary outcome. Cox proportional hazard regression will model predictors of time-to-preterm labour. Expected Outcomes: Short cervical length, elevated corticotrophin-releasing hormone, and reduced progesterone at mid-gestation are anticipated to independently predict preterm delivery, with interleukin-8 amplifying risk in the presence of short cervix. Conclusion: Findings will support the development of a physiologically-grounded preterm labour risk screening protocol for Nigerian primigravidae. Keywords: preterm labour, cervical length, progesterone, corticotrophin-releasing hormone, Gombe.