Biochemical markers for the prediction of spontaneous pre‐term birth

Paternoster, Delia Maria; Stella, Andrea; Gerace, P; Manganelli, Francesca; Plebani, Mario; Snijders, Deborah; Nicolini, Umberto

doi:10.1016/s0020-7292(02)00243-6

Cited by 37 publications

(28 citation statements)

References 13 publications

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“…92 Eleven studies evaluated more than one test. 22,25,26,34,35,38,50,54,55,58,59 One study reported on both inflammation-and coagulation-related biomarkers. 58 The median number of studies per biomarker was two (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14] post-test probability of preterm birth ¼ likelihood ratio Â pre-test probability ½1 À pre-test probability Â ð1 À likelihood ratioÞ:…”

Section: Resultsmentioning

confidence: 99%

Novel biomarkers for the prediction of the spontaneous preterm birth phenotype: a systematic review and meta-analysis

Conde-Agudelo

Papageorghiou

Kennedy

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

141

114

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Background Being able to predict preterm birth is important, as it may allow a high-risk population to be selected for future interventional studies and help in understanding the pathways that lead to preterm birth.Objective To investigate the accuracy of novel biomarkers to predict spontaneous preterm birth in women with singleton pregnancies and no symptoms of preterm labour.Search strategy Electronic searches in PubMed, Embase, Cinahl, Lilacs, and Medion, references of retrieved articles, and conference proceedings. No language restrictions were applied.Selection criteria Observational studies that evaluated the accuracy of biomarkers proposed in the last decade to predict spontaneous preterm birth in asymptomatic women. We excluded studies in which biomarkers were evaluated in women with preterm labour.Data collection and analysis Two reviewers independently extracted data on study characteristics, quality, and accuracy. Data were arranged in 2 · 2 contingency tables and synthesised separately for spontaneous preterm birth before 32, 34, and 37 weeks of gestation. We used bivariate meta-analysis to estimate pooled sensitivities and specificities, and calculated likelihood ratios (LRs).Main results A total of 72 studies, including 89 786 women and evaluating 30 novel biomarkers, met the inclusion criteria. Only three biomarkers (proteome profile and prolactin in cervicovaginal fluid, and matrix metalloproteinase-8 in amniotic fluid) had positive LRs > 10. However, each of these biomarkers was evaluated in only one small study. Four biomarkers had a moderate predictive accuracy (interleukin-6 and angiogenin, in amniotic fluid; human chorionic gonadotrophin and phosphorylated insulin-like growth factor binding protein-1, in cervicovaginal fluid). The remaining biomarkers had low predictive accuracies.Conclusions None of the biomarkers evaluated in this review meet the criteria to be considered a clinically useful test to predict spontaneous preterm birth. Further large, prospective cohort studies are needed to evaluate promising biomarkers such as a proteome profile in cervicovaginal fluid.

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Section: Resultsmentioning

confidence: 99%

Novel biomarkers for the prediction of the spontaneous preterm birth phenotype: a systematic review and meta-analysis

Conde-Agudelo

Papageorghiou

Kennedy

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

141

114

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“…Pregnancy tends to predispose to vagino-cervical infection due to altered vaginal pH. Even in asymptomatic subjects clinical or sub clinical infection can lead to increased ferritin which thereby can help in assessing the possibility of preterm delivery [8].…”

Section: Discussionmentioning

confidence: 99%

Potential Biochemical Markers for Preterm Labor: A Pilot Study in North India

et al. 2010

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Preterm delivery is a major contributor for neonatal mortality. Intensive research is underway to establish a reliable biomarker that can ascertain the risk of preterm delivery in pregnant women. The aim of our study was to evaluate the role of various biochemical parameters as potential biomarker for risk assessment for preterm labor. Forty women presenting with preterm labor and 40 women who delivered at term were included in the study. Parameters that were evaluated include corticotrophin (ACTH), prolactin, thyroid stimulating hormone (TSH), ferritin and Alkaline Phosphatase (ALP). Serum ACTH, ferritin, ALP and Ferritin/Iron ratio were significantly higher in the subjects who delivered prematurely as compared to the controls. Comparison of sensitivity, specificity, likelihood ratio, positive and negative predictive values for different cut offs for ACTH, ferritin, ALP and ferritin/iron ratio was carried out. Ferritin emerged as the best marker with area under curve of 0.96 as compared to 0.88 for ACTH, 0.825 for ALP and 0.735 for ferritin/iron ratio. Our study establishes the superiority of ferritin as a predictive biomarker for preterm labor as compared to the rest of the parameters evaluated.

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“…Recent advances in prenatal health care have markers that facilitate more accurate prediction of preterm birth. The use of biological markers to enhance clinical accuracy in predicting preterm birth has been recently proposed [2][3][4][5] . These tests have high capacity to identify the patients with high risk.…”

Section: Discussionmentioning

confidence: 99%

“…Accurate markers to determine whether a pregnant woman is at high risk for premature delivery would potentially allow improved surveillance and more timely intervention to improve the outcome [2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

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Beta-human chorionic gonadotropin concentrations in cervicovaginal secretions as an early marker of preterm delivery

Sak

Sak²,

Gül³

2010

J Clin Exp Invest

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ÖZETAmaç: Preterm doğum erken belirteci olarak serviko-vajinal sekresyonlardaki koriyonik gonadotropin'in rolünü araştırmak.Yöntemler: Bir önceki doğumu erken doğum veya ikinci trimester düşük öyküsü risk faktörü olan, 25-36 gebelik haftasına sahip 55 gebe çalışmaya alındı. Hastaların tü-münde servikovajinal sekresyonlardaki beta-insan koriyonik gonadotropin (β-hCG) düzeyleri radioimmunassay yöntemiyle ticari bir kit kullanılarak ölçüldü. Bulgular:Gebelerden 25'i preterm, 30'u term doğum yaptı. Term ve preterm doğum yapana gebe grupları arasında yaş, gebelik sayısı ve parite açısından farklılık saptanmadı (P>0.05). Preterm doğum grubunda yenidoğan APGAR skorları ve bebeklerin antropometrik ölçümleri term doğum grubundan anlamlı düşük bulundu (P<0.05). Serviko-vaginal β-hCG düzeyleri; preterm grubunda, term doğum grubuna göre anlamlı yüksek bulundu (sırasıyla 94.7±37.7 mIU/ml ve 35.5±14.8 mIU/ml, P<0.001). Beta-hCG için, 75 mIU/ml cut-off değeri olarak alındığında; duyarlılığı %76, özgüllüğü %91.6, pozitif prediktif değeri %95 ve negatif prediktif değeri %79.9 olarak bulundu. Sonuç: Preterm doğum açısından yüksek riskli hastalarda servikovajinal sekresyonlardaki β-hCG konsantrasyonu iyi bir biyokimyasal belirteç olabilir. Servikovajinal sıvılardaki β-hCG düzeyine dayanarak preterm doğum geliştireceği öngörülen hastalarda daha yakın takip ile komplikasyonlar azaltılabilir. Klin Den Ar Derg 2010; 1(1): [16][17][18][19][20] Anahtar kelimeler: Preterm doğum, beta-hCG, prediktif değer, serviko-vajinal sekresyonlar ABSTRACT Objectives: To investigate beta-human corionic gonadotropin (β-hCG) levels in cervicovaginal secretions as an early marker for preterm delivery. Methods:The study included 55 patients at 25-36 of gestational weeks with preterm delivery risk factors including a history of preterm labor in a previous pregnancy or history of second trimester abortion. Beta-human chorionic gonadotropin (β-hCG) levels of cervicovaginal secretions were measured in all patients by the radioimmunoassay method using a commercial kit.Results: Preterm delivery was observed in 25 patients and 30 patients gave term delivery. No significant differences were found between preterm and term delivery groups in age, gravidity and parity (P>0.05). APGAR scores and anthropometric measurements of newborns were significantly lower in preterm delivery group (P<0.001). Preterm delivery group had significantly higher cervicovaginal β-hCG levels compared with normal controls (94.7±37.7 vs. 35.5±14.8 mIU/ml, respectively, P<0.001). When 75 mIU/ml value of β-hCG level was taken as cut-off value; the sensitivity of the test was found as 76%, specifity 91.6%, positive predictive value 95.0% and negative predictive value as 79.9%. Conclusion:Concentrations of β-hCG in cervicovaginal secretions may be a useful early biochemical marker to detect preterm. Based on β-hCG levels in cervicovaginal secretions a closer follow-up may decrease some complications of preterm delivery.

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Biochemical markers for the prediction of spontaneous pre‐term birth

Abstract: In order to evaluate pregnancies for pre-term labor, the presence of pH>4.5 and a positive fFN test seems to be predictive of subsequent pre-term delivery.

Cited by 37 publications

References 13 publications

Novel biomarkers for the prediction of the spontaneous preterm birth phenotype: a systematic review and meta-analysis

Novel biomarkers for the prediction of the spontaneous preterm birth phenotype: a systematic review and meta-analysis

Potential Biochemical Markers for Preterm Labor: A Pilot Study in North India

Beta-human chorionic gonadotropin concentrations in cervicovaginal secretions as an early marker of preterm delivery

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