Biochemical Markers Predictive of Preterm Delivery

Division of Maternal-Fetal Medicine Department of Obstetrics and Gynecology New York Hospital-Cornell Medical Center 525 E. 68th St. J-130 New York New York 10021 USA.
Infectious Diseases in Obstetrics and Gynecology 02/1997; 5(2):158-64. DOI: 10.1155/S1064744997000240
Source: PubMed


Preterm delivery is the leading cause of perinatal morbidity and mortality worldwide. Despite a great deal of research into this disease, we still do not understand its pathophysiology. Our treatments for this disease are only marginally effective. Biochemical markers were developed with the hope of giving us new tools to prevent preterm deliveries. Specifically the hope was that they could predict which patients were destined to have a preterm delivery. At the present time these markers perform only satisfactorily at predicting preterm labor. They are expensive and not convenient to use at present. Perhaps more importantly, though, these markers have given us insight into the complexities of preterm delivery. Preterm delivery can arise from many different etiologies. This will lead to research into new treatments as knowledge about preterm delivery is amassed. We know that any number of pathological processes may be involved in any given patient with preterm labor. Biochemical markers have the distinct advantage of being able to determine the specific pathophysiology in a given patient and may allow us to tailor therapy according to the specific problem. In the future it is likely that a careful search for specific pathophysiology will be the only way we can treat this disease effectively. For the present time the biochemical markers will be used only to predict preterm delivery. Ultrasound measurements of the cervix during the pregnancy are likely a faster and less expensive way to accomplish that goal.


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    • "Hence, elevated levels of IL-1b, IL-6, TNF-a, PGE2, fibronectin and a-foetoprotein in the amniotic fluid have been associated with PB, while other biomarkers such as MMPs, estriol, elastase, protease, phospholipase, prolactin myeloperoxidase and tissue inhibitor of MMP (TIMP)-1 have been evaluated but with inconclusive results. (Inglis 1997, G€ ursoy et al. 2010). Increased maternal serum levels of pro-inflammatory cytokines, such as IL-1, IL-6, IL-8 and TNF-a, have also been reported to be associated with prematurity or low birthweight (PLBW) (Greig et al. 1997, von Minckwitz et al. 2000, Turhan et al. 2000, G€ ucer et al. 2001, Hitti et al. 2001). "
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    [Show abstract] [Hide abstract] ABSTRACT: Periodontal infections, which serve as a reservoir of inflammatory mediators such as prostaglandin E(2) (PGE(2)), may pose a threat to the fetal-placental unit and cause preterm delivery. This study was conducted to estimate the levels of PGE(2) in gingival crevicular fluid (GCF) and serum to explore the possible use of the GCF-PGE(2) level as a risk predictor of preterm low birth weight (PLBW). Twenty-two pregnant female patients were selected for the study. Samples of GCF and serum were collected from each patient, and sampling was repeated at one month after parturition. The level of PGE(2) in GCF and serum was estimated using a commercially available ELISA kit (NeogenTM). The mean serum PGE(2) level was 4.4 ng/ml and 1.64 ng/ml before and after parturition, respectively, and the difference was statistically significant (P < 0.001). The mean GCF-PGE(2) level was 5.8 ng/ml and 5.5 ng/ml before and after parturition, respectively, but the difference was not significant. There was positive correlation between the serumPGE(2) and GCF-PGE(2) levels, and there was a negative correlation between PGE(2) level and gestational age. The present findings suggest that there is a weak correlation between maternal GCF-PGE(2) level and birth outcome. Further clinical trials with a larger sample size are warranted for further investigation of the association between GCF-PGE(2) level and PLBW.
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