Intercellular Adhesion Molecule-1 (ICAM-1) in Cervicovaginal Fluid of Women Presenting with Preterm Labor: Predictive Value for Preterm Delivery

Authors

  • KEITH W. MARVIN,

  • JEFFREY A. KEELAN,

  • REN LI ZHOU,

  • MURRAY D. MITCHELL,

  • MATTHEW A.G. COLEMAN*,

  • LESLEY M.E. MCCOWAN,

  • MATTHEW A.G. COLEMAN


Address reprint requests to Keith W. Marvin, Ph.D., Department of Pharmacology and Clinical Pharmacology, University of Auckland, Private Bag 92019, Auckland, New Zealand.

Email: k.marvin@auckland.ac.nz

Abstract

PROBLEM: Clinically useful tests for the prediction and diagnosis of preterm labor and delivery remain to be established. We have hypothesized that soluble intercellular adhesion molecule-1 (sICAM-1) in the cervicovaginal fluid of women with preterm labor may be a useful diagnostic tool.
METHOD OF STUDY: The cervicovaginal fluid of 103 women between 240 and 336 weeks gestation with preterm contractions and intact membranes was assayed for sICAM-1.
RESULTS: Elevated sICAM-1 concentrations predicted short intervals to delivery (area under receiver–operator characteristic (ROC) curves, 0.70–0.72 for delivery within 3, 7 and 10 days), with high specificity. Characteristics for delivery within 3 days at a 3 ng/mL threshold for a positive test were sensitivity 33.3%, specificity 98.9%, and positive and negative predictive values of 75.0% and 93.9%, respectively. Predictive ability was independent of and complementary to that of fetal fibronectin (fFN).
CONCLUSIONS: Measurement of sICAM-1 in cervicovaginal fluid has potential as a predictor of preterm delivery in women with symptoms of preterm labor, particularly in conjunction with fFN testing.

Ancillary