Cervico-vaginal placental α-macroglobulin-1 combined with cervical length for the prediction of preterm birth in women with threatened preterm labor.

Radan, Anda-Petronela; Aleksandra Polowy, Justyna; Heverhagen, Anneke; Simillion, Cedric; Baumann, Marc; Raio, Luigi; Schleussner, Ekkehard; Müller, Martin; Surbek, Daniel (2020). Cervico-vaginal placental α-macroglobulin-1 combined with cervical length for the prediction of preterm birth in women with threatened preterm labor. Acta obstetricia et gynecologica Scandinavica, 99(3), pp. 357-363. Wiley-Blackwell 10.1111/aogs.13744

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INTRODUCTION Preterm birth is a major cause of neonatal morbidity and mortality. There is an urgent need to accurately predict imminent delivery to enable necessary interventions such as tocolytic, glucocorticoid, and magnesium sulfate administration. We aimed to evaluate placental α-macroglobulin-1 as a new diagnostic marker in the prediction of preterm birth. MATERIAL AND METHODS We performed a prospective observational trial in women with intact membranes between 24+0 and 36+6 weeks of gestation. We included both women with and without threatened preterm labor symptoms. We evaluated the test performance of placental α-macroglobulin-1 measurements in cervicovaginal fluid regarding three different presentation-to-delivery intervals: ≤2, ≤7, ≤14 days. In addition, we calculated placental α-macroglobulin-1 performance in combination with other prognostic factors such as ultrasonographic cervical length measurements. RESULTS We included 126 women in the study. We detected high specificity (97%-98%) and negative predictive value (89%-97%) for placental α-macroglobulin-1 at all time intervals. We assessed placental α-macroglobulin-1 in combination with cervical length measurements (≤15 mm) in the sub-group of women presenting with threatened preterm labor symptoms (n = 63) and detected high positive predictive values (100%) for 7- and 14-day presentation-to-delivery intervals. CONCLUSIONS Our study provides evidence that placental α-macroglobulin-1 testing in cervicovaginal fluid, in combination with cervical length measurements, accurately predicts preterm birth in women with preterm labor symptoms. This novel test combination may be used clinically to triage women presenting with threatened preterm labor, avoiding overtreatment and unnecessary hospitalizations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Radan, Anda-Petronela; Heverhagen, Anneke; Baumann, Marc; Raio, Luigi; Müller, Martin and Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0001-6349

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Monika Zehr

Date Deposited:

24 Dec 2019 09:17

Last Modified:

22 Feb 2020 01:32

Publisher DOI:

10.1111/aogs.13744

PubMed ID:

31587255

Uncontrolled Keywords:

cervicovaginal fluid cervix placenta placental α-macroglobulin-1 pregnancy preterm birth preterm labor

BORIS DOI:

10.7892/boris.136422

URI:

https://boris.unibe.ch/id/eprint/136422

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