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The Utility of Acute Phase Reactants For Predicting Preterm Delivery in Cases With Threatened Preterm Labor

Year 2015, Volume: 12 Issue: 1, 6 - 9, 01.01.2015

Abstract

Aim: To determine the utility of selected acute phase reactants to predict preterm delivery occurrence in patients with a diagnosis of threatened preterm labor.Material and Methods: Ninety one pregnant women aged 17-38 years and between 26 and 36+6 weeks of gestational age according to last menstrual period were included in the study. A control group comprising 83 healthy singleton pregnant women in similar gestational ages without any medical or obstetrical problems was included. The study group was further divided into two subgroups which had preterm delivery and term delivery. A total of three groups including controls were studied. The serum levels of zinc, copper, albumin, micro-C-reactive protein, ferritin and complete blood count were analyzed. Also, urinalysis and urine culture tests were performed for all participants. Groups were compared for acute phase reactants and p values less than 0.05 were considered statistically significant.Results: Study and control groups did not have any statistically significant difference in terms of gravidity, abortion, live births, maternal age and maternal body mass index p>0.05 . Forty-five 49.4% women in the study group had term delivery, whereas forty-six 50.6% had preterm delivery. Levels of albumin were statistically lower in the study group whereas ferritin levels were higher p0.05 .Conclusion: The study showed that low serum albumin and high ferritin levels had an association with preterm delivery. These parameters can be used as additional markers with interleukin-6 and fetal fibronectin for preterm delivery prediction. Future studies with larger sample sizes are needed to clarify the association between acute phase reactant levels and preterm delivery prediction.

References

  • Ventura SJ, Martin JA, Curtin SC, Mathews TJ, Park MM. Births: final data for 1998. Natl Vital Stat Rep 2000;48: 1-100.
  • López Bernal A, Watson SP, Phaneuf S, Europe-Finner GN. Biochemistry and physiology of preterm labour and delivery. Baillieres Clin Obstet Gy- naecol 1993;7:523-52.
  • Sotiriadis A, Papatheodorou S, Kavvadias A, Makrydimas G. Transvagi- nal cervical length measurement for prediction of preterm birth in women with threatened preterm labor: a meta-analysis. Ultrasound Obstet Gyne- col 2010;35:54-64.
  • Creasy RK. Preterm labor and delivery. In: Creasy RK and Resnik R. Ma- ternal-fetal medicine: principles and practice. Philadelphia: W.B. Saun- ders 1994:494–520.
  • Meis PJ, Goldenberg RL, Mercer BM, Iams JD, The preterm prediction study: risk factors for indicated preterm births. Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Deve- lopment Am J Obstet Gynecol 1998;178:562-7.
  • Kişnişçi H, Gökşin E, Durukan T, Üstay K, Ayhan A, Gürgan T, Önde- roğlu L. Temel Kadın Hastalıkları ve Doğum Bilgisi 1996;1465-1480.
  • Rozenberg P, Goffinet F, Malagrida L, Giudicelli Y, Perdu M, Houssin I, et al. Evaluating the risk of preterm delivery: a comparison of fetal fibrone- ctin and transvaginal ultrasonographic measurement of cervical length. Am J Obstet Gynecol 1997;176:196-9.
  • Yoon BH, Jun JK, Park KH, Syn HC, Gomez R, Romero R. Serum C-rea- ctive protein, white blood cell count, and amniotic fluid white blood cell count in women with preterm premature rupture of membranes. Obstet Gynecol 1996;88:1034-40.
  • Yaylı G.İnfeksiyon hastalıklarında C-reaktif protein, sedimantasyon ve lö- kositler. Ankem Derg 2005;19: 80-4.
  • Baumann H, Gauldie J. The acute phase response. Immunol Today 1994; 15:74-80.
  • Mwaniki MK, Atieno M, Lawn JE, Newton CR. Long-term neurodeve- lopmental outcomes after intrauterine and neonatal insults: a systematic review. Lancet 2012;379 (9814):445-52.
  • Goldenberg RL. The management of preterm labor. Obstet Gynecol 2002;100:1020-37.
  • Vincent JL. Relevance of albumin in modern critical care medicine. Best Pract Res Clin Anaesthesiol 2009;23:183-91.
  • Scholl, T.O. High third-trimester ferritin concentration: associations with very preterm delivery, infection, and maternal nutritional status. Obstet Gynecol 1998;92:161-6.
  • Hawrryshyn P, Bernstein P, Milligan JE, Soldin S, Pollard A, Papsin FR. Premature rupture of membranes: The role of C-reactive protein in the prediction of chorioamnionitis. Am J Obstet Gynecol 1983; 147:240-6.
  • Pacheco LD, Hankins GD, Costantine MM, Anderson GD, Pawelczyk E, Nowicki S, et al. The role of human decay-accelerating factor in the pat- hogenesis of preterm labor. Am J Perinatol 2011;28:565-70.
  • Yuan M, Jordan F, McInnes IB, Harnett MM, Norman JE. Leukocytes are primed in peripheral blood for activation during term and preterm labour. Mol Hum Reprod 2009;15:713-24.
  • Killholma P, Grönroos M, Erkkola P, Pakarinen V, Nöntö V. The role of calcium, copper, iron and zinc in preterm delivery and premature rupture of fetal membranes. Gynecol obstet Invest 1984;17:197

Preterm Eylem Tehdidi Olgularında Akut Faz Reaktanlarının Preterm Doğumu Öngörmedeki Yeri

Year 2015, Volume: 12 Issue: 1, 6 - 9, 01.01.2015

Abstract

Amaç: Preterm eylem tehdidi tanısı almış gebelerde, akut faz reaktanlarının preterm doğumu öngörmedeki yerini araştırmak.Gereç ve Yöntemler: Çalışmaya son adet tarihine göre hesaplanmış 26 hafta ile 36 hafta 6 gün arası gestasyonel yaştaki preterm eylem tehdidi tanısı alan 17- 38 yaş arasındaki 91 gebe dahil edilmiştir. Kontrol grubu olarak, aynı tarihler arasında, benzer gebelik haftasında, herhangi bir medikal veya obstetrik problemi olmayan 83 tekiz gebe alınmıştır. Çalışma grubu kendi içinde terme ulaşan ve preterm doğumla sonuçlanan iki grup ve kontrol grubuyla birlikte üç gruba ayrılmıştır. Gebelerden serum çinko, bakır, albümin, mikro C-reaktif protein, ferritin ve tam kan sayımı tetkikleri gönderilmiş olup ayrıca tam idrar tahlili ve idrar kültürü tetkikleri yapılmıştır. Gruplar akut faz reaktanları açısından karşılaştırılmış p0.05 . Çalışma grubundaki 91 gebenin kırk beşi % 49.4 termde doğum yaparken, kırk altısı % 50.6 preterm doğum yapmıştır. Çalışma grubunda albümin düzeyleri istatistiksel anlamlı düşük bulunurken, ferritin düzeyleri ise anlamlı olarak yüksek saptandı p0.05 .Sonuç: Çalışmamızda artmış ferritin ve azalmış albümin düzeylerinin preterm doğumla ilişkili olabileceği gösterilmiştir. Bu parametreler interlökin-6 ve fibronektine ek bir marker olarak kullanılabilir. Akut faz reaktanlarının, preterm doğumu öngörüsünde kullanılması için bu konuda yapılacak daha geniş çalışmalara ihtiyaç vardır.

References

  • Ventura SJ, Martin JA, Curtin SC, Mathews TJ, Park MM. Births: final data for 1998. Natl Vital Stat Rep 2000;48: 1-100.
  • López Bernal A, Watson SP, Phaneuf S, Europe-Finner GN. Biochemistry and physiology of preterm labour and delivery. Baillieres Clin Obstet Gy- naecol 1993;7:523-52.
  • Sotiriadis A, Papatheodorou S, Kavvadias A, Makrydimas G. Transvagi- nal cervical length measurement for prediction of preterm birth in women with threatened preterm labor: a meta-analysis. Ultrasound Obstet Gyne- col 2010;35:54-64.
  • Creasy RK. Preterm labor and delivery. In: Creasy RK and Resnik R. Ma- ternal-fetal medicine: principles and practice. Philadelphia: W.B. Saun- ders 1994:494–520.
  • Meis PJ, Goldenberg RL, Mercer BM, Iams JD, The preterm prediction study: risk factors for indicated preterm births. Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Deve- lopment Am J Obstet Gynecol 1998;178:562-7.
  • Kişnişçi H, Gökşin E, Durukan T, Üstay K, Ayhan A, Gürgan T, Önde- roğlu L. Temel Kadın Hastalıkları ve Doğum Bilgisi 1996;1465-1480.
  • Rozenberg P, Goffinet F, Malagrida L, Giudicelli Y, Perdu M, Houssin I, et al. Evaluating the risk of preterm delivery: a comparison of fetal fibrone- ctin and transvaginal ultrasonographic measurement of cervical length. Am J Obstet Gynecol 1997;176:196-9.
  • Yoon BH, Jun JK, Park KH, Syn HC, Gomez R, Romero R. Serum C-rea- ctive protein, white blood cell count, and amniotic fluid white blood cell count in women with preterm premature rupture of membranes. Obstet Gynecol 1996;88:1034-40.
  • Yaylı G.İnfeksiyon hastalıklarında C-reaktif protein, sedimantasyon ve lö- kositler. Ankem Derg 2005;19: 80-4.
  • Baumann H, Gauldie J. The acute phase response. Immunol Today 1994; 15:74-80.
  • Mwaniki MK, Atieno M, Lawn JE, Newton CR. Long-term neurodeve- lopmental outcomes after intrauterine and neonatal insults: a systematic review. Lancet 2012;379 (9814):445-52.
  • Goldenberg RL. The management of preterm labor. Obstet Gynecol 2002;100:1020-37.
  • Vincent JL. Relevance of albumin in modern critical care medicine. Best Pract Res Clin Anaesthesiol 2009;23:183-91.
  • Scholl, T.O. High third-trimester ferritin concentration: associations with very preterm delivery, infection, and maternal nutritional status. Obstet Gynecol 1998;92:161-6.
  • Hawrryshyn P, Bernstein P, Milligan JE, Soldin S, Pollard A, Papsin FR. Premature rupture of membranes: The role of C-reactive protein in the prediction of chorioamnionitis. Am J Obstet Gynecol 1983; 147:240-6.
  • Pacheco LD, Hankins GD, Costantine MM, Anderson GD, Pawelczyk E, Nowicki S, et al. The role of human decay-accelerating factor in the pat- hogenesis of preterm labor. Am J Perinatol 2011;28:565-70.
  • Yuan M, Jordan F, McInnes IB, Harnett MM, Norman JE. Leukocytes are primed in peripheral blood for activation during term and preterm labour. Mol Hum Reprod 2009;15:713-24.
  • Killholma P, Grönroos M, Erkkola P, Pakarinen V, Nöntö V. The role of calcium, copper, iron and zinc in preterm delivery and premature rupture of fetal membranes. Gynecol obstet Invest 1984;17:197
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Kerem Doğa Seçkin This is me

Salih Çetinkaya This is me

Mehmet Fatih Karslı This is me

Eralp Başer This is me

Kerem Tetik This is me

Murat Öz This is me

Müzeyyen Gülnur Özakşit This is me

Publication Date January 1, 2015
Published in Issue Year 2015 Volume: 12 Issue: 1

Cite

Vancouver Seçkin KD, Çetinkaya S, Karslı MF, Başer E, Tetik K, Öz M, Özakşit MG. Preterm Eylem Tehdidi Olgularında Akut Faz Reaktanlarının Preterm Doğumu Öngörmedeki Yeri. JGON. 2015;12(1):6-9.