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New biomarkers for the prediction of spontaneous preterm labour in symptomatic pregnant women: a comparison with fetal fibronectin.

Authors :
Liong S
Di Quinzio MK
Fleming G
Permezel M
Rice GE
Georgiou HM
Source :
BJOG : an international journal of obstetrics and gynaecology [BJOG] 2015 Feb; Vol. 122 (3), pp. 370-9. Date of Electronic Publication: 2014 Jul 24.
Publication Year :
2015

Abstract

Objective: To identify cervicovaginal fluid (CVF) biomarkers predictive of spontaneous preterm birth in women with symptoms of preterm labour.<br />Design: Retrospective cohort study.<br />Setting: Melbourne, Australia.<br />Population: Women with a singleton pregnancy admitted to the Emergency Department between 22 and 36 weeks of gestation presenting with symptoms of preterm labour.<br />Methods: Two-dimensional electrophoresis was used to analyse the CVF proteome. Validation of putative biomarkers was performed using enzyme-linked immunosorbent assay (ELISA) in an independent cohort. Optimal concentration thresholds of putative biomarkers were determined and the predictive efficacy for preterm birth was compared with that of fetal fibronectin.<br />Main Outcome Measures: Prediction of spontaneous preterm labour within 7 days.<br />Results: Differentially expressed proteins were identified by proteomic analysis in women presenting with 'threatened' preterm labour without cervical change who subsequently delivered preterm (n = 12 women). ELISA validation using an independent cohort (n = 129 women) found albumin and vitamin D-binding protein (VDBP) to be significantly altered between women who subsequently experienced preterm birth and those who delivered at term. Prediction of preterm delivery within 7 days using a dual biomarker model (albumin/VDBP) provided 66.7% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 96.7% negative predictive value (NPV), compared with fetal fibronectin yielding 66.7, 87.9, 36.4 and 96.2%, respectively (n = 64). Using the maximum number of screened samples, the predictive utility of albumin/VDBP yielded a sensitivity of 77.8%, specificity and PPV of 100% and NPV of 98.0% (n = 109).<br />Conclusions: The dual biomarker model of albumin/VDBP is more efficacious than fetal fibronectin in predicting spontaneous preterm delivery in symptomatic women within 7 days. A clinical diagnostic trial is required to test this model on a larger population to confirm these findings and to further refine the predictive values.<br /> (© 2014 Royal College of Obstetricians and Gynaecologists.)

Details

Language :
English
ISSN :
1471-0528
Volume :
122
Issue :
3
Database :
MEDLINE
Journal :
BJOG : an international journal of obstetrics and gynaecology
Publication Type :
Academic Journal
Accession number :
25056135
Full Text :
https://doi.org/10.1111/1471-0528.12993