The preterm prediction study: elevated cervical ferritin levels at 22 to 24 weeks of gestation are associated with spontaneous preterm delivery in asymptomatic women.
ABSTRACT Low serum ferritin levels correlate with low iron stores, whereas high levels are associated with an acute-phase reaction. Our objective was to determine whether elevated levels of ferritin in the genital tract may be a potent marker to identify patients at risk for spontaneous preterm delivery.
We performed a nested case-control study involving 182 women who had spontaneous preterm delivery and 182 term control subjects matched for race, parity, and recruitment center, and selected from 2929 women enrolled in the Preterm Prediction Study of the National Institute of Child Health and Development Maternal-Fetal Medicine Units Network. Cervical fluid ferritin was measured by use of radioimmunoassay.
Cervical ferritin levels were significantly higher in women who subsequently had spontaneous early preterm delivery (<32 weeks, mean +/- SD, 37.7 +/- 31.1 vs 21.5 +/- 24.1 ng/mL, P =.002; and <35 weeks, 43.2 +/- 62.7 vs 28.2 +/- 36.7 ng/mL, P =.004) than in term controls. A cervical ferritin of >75th percentile in the controls (>35.5 ng/mL) was found in 52.9% (9/17) of the women delivered <29 weeks vs 17.7% (3/17) of the controls (odds ratio [OR] 5.3 [95% CI 1.1-25.2]) and in 43.5% (20/46) of the women delivered <32 weeks versus 10.9% (5/46) of the controls (OR 6.3, 95% CI 2.1-18.9). Cervical ferritin levels had a weaker association with spontaneous preterm delivery <35 weeks (OR 2.8 [95% CI 1.5-5.1]) and <37 weeks (OR 1.6, 95% CI 1.0-2.5]). Cervical ferritin levels correlated significantly with cervical lactoferrin, interleukin-6 (IL-6), and defensin levels.
Elevated cervical ferritin levels at 22 to 24 weeks of gestation in asymptomatic women are associated with subsequent spontaneous preterm birth. The strong correlation of cervical ferritin with other inflammatory markers provides support for the hypothesis of infection as a mediator of preterm delivery.
- Seminars in Hematology 02/1977; 14(1):71-88. · 3.36 Impact Factor
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ABSTRACT: The use of a new monoclonal antibody (MoAb) enzymoassay for the specific measurement of placental ferritin (PLF) enabled it to be quantitatively determined in the sera of pregnant women, women at full-term and preterm delivery, and in their newborns. High levels of PLF were measured in the sera of pregnant women at 17 weeks of gestation up to full-term delivery as compared with normal adult women who mostly lack PLF. The level of PLF in the serum was irrespective of the total ferritin level. In full-term newborns, PLF concentration was lower than that found in their mothers although it increased compared to healthy adults. It was further found that in the blood of women who delivered at 29-36 weeks, PLF was undetected or was very low. Accordingly their preterm infants also exhibited very low or undetectable PLF in their serum. These results suggest the possible use of PLF as a prognostic indicator in pregnancy.Clinical & Experimental Immunology 10/1987; 69(3):702-6. · 3.41 Impact Factor
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ABSTRACT: The concentrations of acute-phase protein reactants, total protein, albumin and globulin fractions were measured throughout normal pregnancy in 27 women. alpha 1-Antitrypsin and caeruloplasmin concentrations increased gradually to reach their highest levels in the third trimester. Orosomucoid and haptoglobin showed similar patterns: higher levels in the first and third trimester with a decline around 24 weeks gestation. C-Reactive protein showed levels similar to those of non-pregnant healthy individuals (less than 5 mg/l) throughout pregnancy. alpha 1-, alpha 2- and beta-Globulin concentrations increased from the first trimester towards term. gamma-Globulin concentration changed little during gestation. The data obtained provide reference ranges for serum proteins in healthy pregnancy.British Journal of Obstetrics and Gynaecology 03/1983; 90(2):139-45.