Serum relaxin and cervical length for prediction of spontaneous preterm birth in second-trimester symptomatic women.
Title | Serum relaxin and cervical length for prediction of spontaneous preterm birth in second-trimester symptomatic women. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Pantelis, A., Sotiriadis A., Chatzistamatiou K., Pratilas G., & Dinas K. |
Journal | Ultrasound Obstet Gynecol |
Volume | 52 |
Issue | 6 |
Pagination | 763-768 |
Date Published | 2018 Dec |
ISSN | 1469-0705 |
Keywords | Adult, Case-Control Studies, Cervical Length Measurement, Cervix Uteri, Female, Humans, Logistic Models, Maternal Age, Pregnancy, Pregnancy Trimester, Second, Premature Birth, Relaxin, ROC Curve |
Abstract | OBJECTIVE: To investigate whether serum relaxin level is associated with preterm birth in symptomatic women, either as a standalone test or in the context of a combined model of serum relaxin and cervical length (CL).METHODS: This was a case-control study of women with a singleton pregnancy who presented between 24 + 0 and 26 + 6 weeks' gestation with threatened preterm labor and intact membranes. CL, full blood count, C-reactive protein level and maternal demographics were recorded at presentation, and blood samples were taken for relaxin measurement. Parameters were compared between women who delivered preterm (before 37 weeks) (n = 46) and those delivering at term (n = 66). Logistic regression with receiver-operating characteristics (ROC) curve analysis was used to assess significant predictors for birth before 37 and before 34 weeks.RESULTS: Women delivering before 37 weeks had higher mean serum relaxin levels and lower mean CL than those delivering at term (P < 0.0001). Relaxin alone had 63% (95% CI, 49-75%) sensitivity for birth before 37 weeks and 61% (95% CI, 47-74%) for birth before 34 weeks, at a 10% false-positive rate (FPR). Serum relaxin levels did not correlate with CL; a combined model of the two predictors had an area under the ROC curve of 0.895 (95%CI, 0.835-0.954) for the prediction of birth before 37 weeks and 0.869 (95% CI, 0.802-0.937) for birth before 34 weeks (n = 44). Serum relaxin > 1010 pg/mL had 58% sensitivity for prediction of preterm birth in women with a CL > 15 mm, at a 10% FPR.CONCLUSIONS: High serum relaxin level is associated with an increased risk of preterm birth in second-trimester symptomatic women with intact membranes. A combination of serum relaxin and CL increases predictive accuracy for preterm birth. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. |
DOI | 10.1002/uog.18972 |
Alternate Journal | Ultrasound Obstet Gynecol |
PubMed ID | 29205573 |