%0 Journal Article
%T Can Preterm Labour Be Predicted in Low Risk Pregnancies? Role of Clinical, Sonographic, and Biochemical Markers
%A Reva Tripathi
%A Shakun Tyagi
%A Nilanchali Singh
%A Yedla Manikya Mala
%A Chanchal Singh
%A Preena Bhalla
%A Siddhartha Ramji
%J Journal of Pregnancy
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/623269
%X Background and Objectives. This is a prospective nested cohort study conducted over a period of 3 years. 2644 women were recruited, out of which final analysis was done for 1884 women. Methods. Cervicovaginal and blood samples were collected for all recruited women. Out of these, 137 women who delivered before 35 weeks were treated as cases and equal number of matched controls were chosen. Analysis of samples for serum G-CSF, AFP, ferritin, and cervicovaginal interleukin-6 and IGFBP-1 was done. Results. Poor orodental hygiene, which can be a social marker, was significantly more common in women who delivered preterm (). Serum alkaline phosphatase and serum ferritin were found to be significantly associated with preterm deliveries. The 90th percentile value of these parameters was considered as cut-off as there is no specific cut-off. Conclusions. Our study did not prove usefulness of any predictive marker. Serum ferritin and alkaline phosphatase were found to have correlation but their values are affected in many conditions and need to be elucidated with caution. Larger studies are needed for predicting preterm labour in asymptomatic women. 1. Introduction Prematurity continues to be the major cause of neonatal morbidity and mortality across the world accounting for an enormous 70% of neonatal deaths in nonanomalous babies [1]. Despite decades of research, we are no closer to finding answers in terms of prediction and hence prevention of preterm labour. This is in sharp contrast to the increasing rates of preterm births across the world. This increase is in part attributable to increase in artificial reproductive techniques and multiple pregnancies. Efforts to predict preterm delivery have classically been based on history and examination findings only. But these risk assessment scores have poor predictive values [2, 3]. Some studies have found cervical length as measured by transvaginal ultrasound and cervicovaginal IGFBP-1 as most strongly and consistently associated with subsequent spontaneous preterm birth [4]. Increased level of cervicovaginal interleukin-6 (IL-6) at 24 weeks has also been associated with preterm delivery [5]. New biochemical markers like increased levels of serum ferritin, serum granulocyte colony-stimulating factor, serum alkaline phosphatase, and serum alpha-fetoprotein have also been associated with increased incidence of preterm delivery [6, 7]. Combining these markers with clinical findings and ultrasonography has also contributed significantly to increased predictive values [4]. We wanted to validate various screening tests
%U http://www.hindawi.com/journals/jp/2014/623269/