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Am J Obstet Gynecol. 2013 Jun;208(6):492.e1-11. doi: 10.1016/j.ajog.2013.02.012. Epub 2013 Feb 24.

Association of early-preterm birth with abnormal levels of routinely collected first- and second-trimester biomarkers.

Author information

1
Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA. Laura.Jelliffe@cdph.ca.gov

Abstract

OBJECTIVE:

The purpose of this study was to examine the relationship between typically measured prenatal screening biomarkers and early-preterm birth in euploid pregnancies.

STUDY DESIGN:

The study included 345 early-preterm cases (<30 weeks of gestation) and 1725 control subjects who were drawn from a population-based sample of California pregnancies who had both first- and second-trimester screening results. Logistic regression analyses were used to compare patterns of biomarkers in cases and control subjects and to develop predictive models. Replicability of the biomarker early-preterm relationships that was revealed by the models was evaluated by examination of the frequency and associated adjusted relative risks (RRs) for early-preterm birth and for preterm birth in general (<37 weeks of gestation) in pregnancies with identified abnormal markers compared with pregnancies without these markers in a subsequent independent California cohort of screened pregnancies (n = 76,588).

RESULTS:

The final model for early-preterm birth included first-trimester pregnancy-associated plasma protein A in the ≤5th percentile, second-trimester alpha-fetoprotein in the ≥95th percentile, and second-trimester inhibin in the ≥95th percentile (odds ratios, 2.3-3.6). In general, pregnancies in the subsequent cohort with a biomarker pattern that were found to be associated with early-preterm delivery in the first sample were at an increased risk for early-preterm birth and preterm birth in general (<37 weeks of gestation; adjusted RR, 1.6-27.4). Pregnancies with ≥2 biomarker abnormalities were at particularly increased risk (adjusted RR, 3.6-27.4).

CONCLUSION:

When considered across cohorts and in combination, abnormalities in routinely collected biomarkers reveal predictable risks for early-preterm birth.

PMID:
23395922
PMCID:
PMC3672244
DOI:
10.1016/j.ajog.2013.02.012
[Indexed for MEDLINE]
Free PMC Article

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