|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|
|Date Published||2013 Jun|
|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|
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.
|Alternate Journal||Am. J. Obstet. Gynecol.|
|PubMed Central ID||PMC3672244|
|Grant List||RC2 HL101748 / HL / NHLBI NIH HHS / United States|