Title | Association of early-preterm birth with abnormal levels of routinely collected first- and second-trimester biomarkers. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Jelliffe-Pawlowski LL, Shaw GM, Currier RJ, Stevenson DK, Baer RJ, O'Brodovich HM, Gould JB |
Journal | Am J Obstet Gynecol |
Volume | 208 |
Issue | 6 |
Pagination | 492.e1-11 |
Date Published | 2013 Jun |
ISSN | 1097-6868 |
Keywords | Adolescent, Adult, alpha-Fetoproteins, Biomarkers, California, Case-Control Studies, Cohort Studies, Female, Humans, Logistic Models, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Pregnancy-Associated Plasma Protein-A, Premature Birth, Prenatal Diagnosis, Risk, Young Adult |
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. |
DOI | 10.1016/j.ajog.2013.02.012 |
Alternate Journal | Am. J. Obstet. Gynecol. |
PubMed ID | 23395922 |
PubMed Central ID | PMC3672244 |
Grant List | RC2 HL101748 / HL / NHLBI NIH HHS / United States |