The diagnostic value of cervicovaginal and serum ferritin levels in midgestation time to predict spontaneous preterm delivery

Abstract

Background:The aim of this study was to determine diagnostic value of cervicovaginal ferretin and serum ferretin levels at midgestation time in predicting preterm delivery in singleton pregnancies.Patients and Methods:A diagnostic test study through a prospective cohort design was carried out on 300 singleton pregnant women in 2012. A blood sample was obtained from all the patients within 22-24 gestational weeks for laboratory assessment of serum ferretin, and cervicovaginal sample was also taken to assess cervicovaginal ferritin level. Ferritin levels were compared between term and preterm deliveries at 37, 34 and 32 weeks of gestation. Receiver operating characteristics (ROC) curves were plotted to assess the diagnostic test values.Results:Mean serum ferritin level was 55.38 [standard deviation (SD 23.8)] ng/mL in term deliveries versus a mean of 91.27 (SD 25.2) ng/mL in preterm deliveries, which showed a statistically significant difference (P < 0.001). The ferritin levels in cervicovaginal term delivery group had mean of 11.29 (SD 16.2) ng/mL compared with a mean of 21.95 (SD 10.1) ng/mL among those with preterm delivery before 37 weeks of gestational age(P < 0.001). The cervicovaginal ferritin level had a moderate to good diagnostic value with an area under curve being above 0.8 for all assessments. The serum ferritin level had a moderate to good diagnostic value with an area under curve being above 0.8 for all assessments. In both tests, its diagnostic value was higher for predicting preterm delivery at earlier gestational age.Conclusions:The results of this study indicate that high levels of serum and cervicovaginal ferritin in singleton pregnancies may alert the clinician of the risk of preterm delivery. Serum and cervicovaginal ferritin measurement at midgestation may be used as a predictive scale for preterm delivery in singleton pregnancies.

Association of Serum Magnesium with Preterm Labor

“…It was found that more than half (61%) patients were ≥ 2 (Multi gravida) and it was also observed by Broumand 8 . In another study Khan 9 observed multigravida was 58.1% in preterm labor.…”

The Potential of Metabolomic Analyses as Predictive Biomarkers of Preterm Delivery: A Systematic Review

“…The precise mechanism by which ferritin contributes to disease is unclear, though. Ramsey et al (16) saw a significant association between elevated cervical ferritin levels and subsequent spontaneous preterm birth along with Broumand et al (17), who also investigated serum levels of ferritin. However, cervicovaginal ferritin correlated poorly with serum ferritin levels as well as serum inflammatory markers such as interleukin 6.…”

“…Cervical ferritin levels had a weaker association with spontaneous preterm birth under 35 weeks and 37 weeks, suggesting that the correlation is higher in very early preterm delivery especially with serum ferritin. Broumand et al (17) analysed ferritin levels in the cervicovaginal fluid using a cervicovaginal swab and the serum levels of ferritin in 280 women between 22 and 24 weeks of gestation and classified subsequent deliveries prospectively into preterm deliveries (<37+0 weeks of gestation), early preterm deliveries (<34+0 weeks of gestation) and very early preterm deliveries (<32+0 weeks of gestation). The mean serum ferritin level was significantly lower in term deliveries versus early and very early preterm deliveries.…”

Serum Ferritin Levels in Pregnant Women with Preterm and Term Deliveries

“…Preterm delivery, as the precedent of prematurity, is generally referred to childbirth before 37 weeks of pregnancy. It is considered not only as a main cause of neonatal mortality, but also, as a risk factor of behavioral problems even later through the child's life [1]. Recent experimental and clinical evidence have revealed an association between intrauterine inflammatory processes and preterm delivery.…”