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

作者：Jelliffe Pawlowski Laura L^*; Shaw Gary M; Currier Robert J; Stevenson David K; Baer Rebecca J; O'Brodovich Hugh M; Gould Jeffrey B

来源：American Journal of Obstetrics and Gynecology, 2013, 208(6): 492.e1.

DOI：10.1016/j.ajog.2013.02.012

• biomarker
• prenatal screening
• preterm birth

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.

• 出版日期2013-6