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Serum markers for prediction of spontaneous preterm delivery in preterm labour

Authors
 Min-A Kim  ;  Byung Seok Lee  ;  Yong-Won Park  ;  Kyung Seo 
Citation
 EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Vol.41(7) : 773-780, 2011 
Journal Title
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
ISSN
 0014-2972 
Issue Date
2011
MeSH
Adult ; Biomarkers/blood ; C-Reactive Protein/analysis ; Cervical Length Measurement ; Cervix Uteri/pathology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Inflammation Mediators/blood ; Kaplan-Meier Estimate ; Leukocyte Count ; Maternal Age ; Pregnancy ; Pregnancy Outcome ; Premature Birth/diagnosis* ; Prognosis ; Retrospective Studies
Keywords
Cervix length ; neutrophil to lymphocyte ratio ; preterm delivery ; serum marker
Abstract
BACKGROUND: Simple, more sensitive markers to predict spontaneous preterm delivery in preterm labour are needed. The aim of this study is to compare the clinical effectiveness of various serum inflammatory markers and cervix length for prediction of spontaneous preterm delivery.

MATERIALS AND METHODS: We retrospectively reviewed medical records of 175 patients hospitalized for preterm labour (102 with preterm delivery and 73 with term delivery). For all study subjects, haematological markers and cervix length were recorded on admission. Because neutrophil to lymphocyte ratio (NLR) showed the potential as a diagnostic marker, we designed a combined marker by dividing cervix length by NLR. The diagnostic and prognostic accuracy of the combined marker was analysed using multivariate analyses.

RESULTS: The levels of combined marker (P < 0·001), neutrophil (P < 0·001), lymphocyte (P = 0·02), NLR (P < 0·001), C-reactive protein (P = 0·016) and the cervix length (P < 0·001) in preterm delivery group were significantly different from those of term delivery group. Compared to cervix length or systemic inflammatory markers alone, combined marker showed higher sensitivity (64·2%) and specificity (88·3%) for prediction of preterm delivery. On Cox multivariate analysis, combined marker positive (< 0·29) and short cervix length (< 1·7 cm) were independent poor prognostic factors and combined marker positive was the most powerful prognostic marker for spontaneous preterm delivery (hazard ratio = 5·60, P < 0·001). Conclusions: Combined marker could be used as a simple and sensitive parameter for identifying women at risk of spontaneous preterm delivery.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2362.2011.02469.x/abstract
DOI
10.1111/j.1365-2362.2011.02469.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Won(박용원)
Seo, Kyung(서경)
Lee, Byung Seok(이병석) ORCID logo https://orcid.org/0000-0001-6001-2079
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93335
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