Serum markers for prediction of spontaneous preterm delivery in preterm labour
Version of Record online: 8 FEB 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 41, Issue 7, pages 773–780, July 2011
How to Cite
Kim, M.-A., Lee, B. S., Park, Y.-W. and Seo, K. (2011), Serum markers for prediction of spontaneous preterm delivery in preterm labour. European Journal of Clinical Investigation, 41: 773–780. doi: 10.1111/j.1365-2362.2011.02469.x
- Issue online: 9 JUN 2011
- Version of Record online: 8 FEB 2011
- Received 27 January 2010; accepted 22 December 2010
- Cervix length;
- neutrophil to lymphocyte ratio;
- preterm delivery;
- serum marker
Eur J Clin Invest 2011; 41 (7): 773–780
Background Simple, more sensitive markers to predict spontaneous preterm delivery in preterm labour are needed. The aim of this study is to compare the clinical effectiveness of various serum inflammatory markers and cervix length for prediction of spontaneous preterm delivery.
Materials and methods We retrospectively reviewed medical records of 175 patients hospitalized for preterm labour (102 with preterm delivery and 73 with term delivery). For all study subjects, haematological markers and cervix length were recorded on admission. Because neutrophil to lymphocyte ratio (NLR) showed the potential as a diagnostic marker, we designed a combined marker by dividing cervix length by NLR. The diagnostic and prognostic accuracy of the combined marker was analysed using multivariate analyses.
Results The levels of combined marker (P < 0·001), neutrophil (P < 0·001), lymphocyte (P = 0·02), NLR (P < 0·001), C-reactive protein (P = 0·016) and the cervix length (P < 0·001) in preterm delivery group were significantly different from those of term delivery group. Compared to cervix length or systemic inflammatory markers alone, combined marker showed higher sensitivity (64·2%) and specificity (88·3%) for prediction of preterm delivery. On Cox multivariate analysis, combined marker positive (< 0·29) and short cervix length (< 1·7 cm) were independent poor prognostic factors and combined marker positive was the most powerful prognostic marker for spontaneous preterm delivery (hazard ratio = 5·60, P < 0·001).
Conclusions Combined marker could be used as a simple and sensitive parameter for identifying women at risk of spontaneous preterm delivery.