Preterm labor is a serious concern that can lead to preterm birth, posing substantial risks for both the mother and the neonate. Despite approximately 15 million preterm births worldwide each year, there is a lack of sufficient strategies for predicting and preventing preterm labor. Here, we present a non-invasive method for simultaneously detecting exosomal miRNA and protein biomarkers in vaginal discharge, enabling early diagnosis of life-threatening conditions in both the mother and the neonate. Our non-invasive vaginal discharge biopsy using a swab enables the isolation of enriched intact extracellular vesicles through our microfluidic platform called Biologically-intact Exosome Separation Technology (BEST). We observed differential expression of specific miRNAs, including up-regulated hsa-miR-206 and down-regulated hsa-miR-3674, hsa-miR-365a-5p, and hsa-miR-193b-3p, in mothers experiencing preterm labor. We also found significant differences in protein expression in mothers with preterm labor compared to full-term mothers, indicating the involvement of HGS, ATL3, APOH, and GUSB in preterm labor mechanisms. We envision a future in which non-invasive detection of unique miRNA and protein biomarkers in vaginal discharge transforms global healthcare by enabling early detection and effective treatment of preterm labor.
Kim et al. (2026) studied this question.