全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Can Preterm Labour Be Predicted in Low Risk Pregnancies? Role of Clinical, Sonographic, and Biochemical Markers

DOI: 10.1155/2014/623269

Full-Text   Cite this paper   Add to My Lib

Abstract:

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

References

[1]  S. W. Wen, G. Smith, Q. Yang, and M. Walker, “Epidemiology of preterm birth and neonatal outcome,” Seminars in Fetal and Neonatal Medicine, vol. 9, no. 6, pp. 429–435, 2004.
[2]  A. Lembet, D. Eroglu, T. Ergin, et al., “New rapid bed-side test to predict preterm delivery: phosphorylated insulin-like growth factor binding protein-1 in cervical secretions,” Acta Obstetricia et Gynecologica Scandinavica, vol. 81, no. 8, pp. 706–712, 2002.
[3]  K. Kwek, C. Khi, H. S. Ting, and G. S. H. Yeo, “Evaluation of a bedside test for phosphorylated insulin-like growth factor binding protein-1 in preterm labour,” Annals of the Academy of Medicine Singapore, vol. 33, no. 6, pp. 780–783, 2004.
[4]  F. Akercan, M. Kazandi, F. Sendag et al., “Value of cervical phosphorylated insulinlike growth factor binding protein-1 in the prediction of preterm labor,” Journal of Reproductive Medicine for the Obstetrician and Gynecologist, vol. 49, no. 5, pp. 368–372, 2004.
[5]  S. E. Elizur, Y. Yinon, G. S. Epatein, D. S. Seidman, E. Schiff, and E. Sivan, “Insulin-like growth factor binding protein-1 detection in preterm labor: evaluation of a bedside test,” American Journal of Perinatology, vol. 22, no. 6, pp. 305–309, 2005.
[6]  P.-Y. Ancel, M.-J. Saurel-Cubizolles, G. C. Di Renzo, E. Papiernik, and G. Breart, “Very and moderate preterm births: are the risk factors different?” The British Journal of Obstetrics and Gynaecology, vol. 106, no. 11, pp. 1162–1170, 1999.
[7]  N. B. Kyrldund-Blomberg and S. Cnattingius, “Preterm birth and maternal smoking: Risks related to gestational age and onset of delivery,” American Journal of Obstetrics and Gynecology, vol. 179, no. 4, pp. 1051–1055, 1998.
[8]  S. S. Hassan, R. Romero, D. Vidyadhari, et al., “Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial,” Ultrasound in Obstetrics & Gynecology, vol. 38, no. 1, pp. 18–31, 2011.
[9]  R. Romero, K. Nicolaides, A. Conde-Agudelo, et al., “Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data,” The American Journal of Obstetrics & Gynecology, vol. 206, pp. 124.e1–124.e19, 2012.
[10]  M. Kurkinen-R?ty, A. Ruokonen, S. Vuopala et al., “Combination of cervical interleukin-6 and -8, phosphorylated insulin-like growth factor-binding protein-1 and transvaginal cervical ultrasonography in assessment of the risk of preterm birth,” British Journal of Obstetrics and Gynaecology, vol. 108, no. 8, pp. 875–881, 2001.
[11]  J. Lumley, “The epidemiology of preterm birth,” Bailliere's Clinical Obstetrics and Gynaecology, vol. 7, no. 3, pp. 477–498, 1993.
[12]  D. S. Guzick and K. Winn, “The association of chorioamnionitis with preterm delivery,” Obstetrics and Gynecology, vol. 65, no. 1, pp. 11–16, 1985.
[13]  P.-Y. Ancel, M.-J. Saurel-Cubizolles, G. C. di Renzo, E. Papiernik, and G. Breart, “Very and moderate preterm births: are the risk factors different?” British Journal of Obstetrics and Gynaecology, vol. 106, no. 11, pp. 1162–1170, 1999.
[14]  N. B. Kyrldund-Blomberg and S. Cnattingius, “Preterm birth and maternal smoking: risks related to gestational age and onset of delivery,” American Journal of Obstetrics and Gynecology, vol. 179, no. 4, pp. 1051–1055, 1998.
[15]  S. Cnattingius, F. Granath, G. Petersson, and B. L. Harlow, “The influence of gestational age and smoking habits on the risk of subsequent preterm deliveries,” The New England Journal of Medicine, vol. 341, no. 13, pp. 943–948, 1999.
[16]  J. Owen, N. Yost, V. Berghella et al., “Mid-trimester endovaginal sonography in women at high risk for spontaneous preterm birth,” Journal of the American Medical Association, vol. 286, no. 11, pp. 1340–1348, 2001.
[17]  W. W. Andrews, R. Copper, J. C. Hauth, R. L. Goldenberg, C. Neely, and M. Dubard, “Second-trimester cervical ultrasound: associations with increased risk for recurrent early spontaneous delivery,” Obstetrics and Gynecology, vol. 95, no. 2, pp. 222–226, 2000.
[18]  V. C. Heath, G. Daskalakis, A. Zagaliki, M. Carvalho, and K. H. Nicolaides, “Cervicovaginal fibronectin and cervical lenth at 23 weeks of gestation: relative risk of early preterm delivery,” British Journal of Obstetrics and Gynaecology, vol. 107, no. 10, pp. 1276–1281, 2000.
[19]  J. M. G. Crane and D. Hutchens, “Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review,” Ultrasound in Obstetrics and Gynecology, vol. 31, no. 5, pp. 579–587, 2008.
[20]  M. H. B. de Carvalho, R. E. Bittar, M. D. L. Brizot, C. Bicudo, and M. Zugaib, “Prediction of preterm delivery in the second trimester,” Obstetrics and Gynecology, vol. 105, no. 3, pp. 532–536, 2005.
[21]  M. A. G. Coleman, J. A. Keelan, L. M. E. McCowan, K. M. Townend, and M. D. Mitchell, “Predicting preterm delivery: comparison of cervicovaginal interleukin (IL)-1, IL-6 and IL-8 with fetal fibronectin and cervical dilatation,” European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 95, no. 2, pp. 154–158, 2001.
[22]  J. Dowd, N. Laham, G. Rice, S. Brennecke, and M. Permezel, “Elevated interleukin-8 concentrations in cervical secretions are associated with preterm labour,” Gynecologic and Obstetric Investigation, vol. 51, no. 3, pp. 165–168, 2001.
[23]  R. L. Goldenberg, W. W. Andrews, B. M. Mercer, et al., “The preterm prediction study: granulocyte colony-stimulating factor and spontaneous preterm birth,” American Journal of Obstetrics & Gynecology, vol. 182, no. 3, pp. 625–630, 2000.
[24]  A. H. Moawad, R. L. Goldenberg, B. Mercer et al., “The Preterm Prediction Study: the value of serum alkaline phosphatase, α-fetoprotein, plasma corticotropin-releasing hormone, and other serum markers for the prediction of spontaneous preterm birth,” The American Journal of Obstetrics and Gynecology, vol. 186, no. 5, pp. 990–996, 2002.
[25]  R. Xiao, T. K. Sorensen, I. O. Frederick et al., “Maternal second-trimester serum ferritin concentrations and subsequent risk of preterm delivery,” Paediatric and Perinatal Epidemiology, vol. 16, no. 4, pp. 297–304, 2002.
[26]  H.-S. Ting, P.-S. Chin, G. S. Yeo, and K. Kwek, “Comparison of bedside test kits for prediction of preterm delivery: phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1) test and fetal fibronectin test,” Annals of the Academy of Medicine, vol. 36, no. 6, pp. 399–402, 2007.
[27]  A. Lembet, D. Eroglu, T. Ergin et al., “New rapid bed-side test to predict preterm delivery: phosphorylated insulin-like growth factor binding protein-1 in cervical secretions,” Acta Obstetricia et Gynecologica Scandinavica, vol. 81, no. 8, pp. 706–712, 2002.
[28]  P. S. Ramsey, T. Tamura, R. L. Goldenberg et al., “The preterm prediction study: elevated cervical ferritin levels at 22 to 24 weeks of gestation are associated with spontaneous preterm delivery in asymptomatic women,” The American Journal of Obstetrics and Gynecology, vol. 186, no. 3, pp. 458–463, 2002.
[29]  S. Liong, M. di Quinzio, G. Fleming, M. Permezel, G. Rice, and H. Georgiou, “New biomarkers for the spontaneous labour symptomatic pregnant women: a comparison with fetal fibronectin,” BJOG, 2014.
[30]  I. Tency, M. Temmerman, and M. Vaneechoutte, “Inflammatory response in maternal serum during preterm labour,” Facts, Views & Vision in Obgyn, vol. 6, no. 1, pp. 19–30, 2014.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133

WeChat 1538708413