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New biomarkers for the prediction of spontaneous preterm labour in symptomatic pregnant women: a comparison with fetal fibronectin.
- 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.)
- Subjects :
- Adult
Albumins metabolism
Australia epidemiology
Biomarkers metabolism
Body Fluids chemistry
Cervix Uteri chemistry
Cohort Studies
Enzyme-Linked Immunosorbent Assay
Female
Humans
Obstetric Labor, Premature prevention & control
Predictive Value of Tests
Pregnancy
Receptors, Interleukin-7 metabolism
Retrospective Studies
Sensitivity and Specificity
Vagina chemistry
Vitamin D-Binding Protein metabolism
Body Fluids metabolism
Cervix Uteri metabolism
Fibronectins metabolism
Obstetric Labor, Premature diagnosis
Vagina metabolism
Subjects
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