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Preterm delivery predicted by soluble CD163 and CRP in women with symptoms of preterm delivery
Author(s) -
Vogel Ida,
Grove Jakob,
Thorsen Poul,
Moestrup Søren K.,
Uldbjerg Niels,
Møller Holger Jon
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2005.00557.x
Subject(s) - medicine , preterm delivery , logistic regression , gestational age , gestation , obstetrics , prospective cohort study , rupture of membranes , population , pregnancy , genetics , biology , environmental health
Objective To evaluate whether soluble CD163 (sCD163) and C‐reactive protein (CRP) can predict spontaneous preterm delivery in women with symptoms of preterm delivery. Design Prospective cohort study. Setting Labour ward at a tertiary university hospital. Population Ninety‐three women with symptoms of preterm delivery before 34 weeks of gestation. Methods sCD163 and CRP were individually examined as predictors of preterm delivery. A model for prediction of preterm delivery was established using exact logistic regression for risk factors individually associated with preterm delivery. Main outcome measures Gestational age at delivery. Results In women with symptoms of preterm delivery, median sCD163 and CRP levels were significantly higher statistically in women delivering preterm (3.4 mg/L, and 62 nmol/L) compared with the women delivering at term (2.7 mg/L, and <48 nmol/L, Mann–Whitney U test, P < 0.01 and P < 0.001) for sCD163 and CRP, respectively. sCD163 above 5 mg/L was associated with an increased risk of preterm delivery (crude OR = 10, [95% CI 1.3–466], adjusted OR = 27, [0.7–∞]). CRP above 47 mg/L was associated with an increased risk of preterm delivery (crude OR = 5 [1.8–14], adjusted OR = 5 [1.04–31]). Likelihood ratio of a positive test was 8.6 [2.8–14] and 2.8 [0–6.2] for sCD163 and CRP, respectively. The logistic regression model was able to predict 85% of preterm deliveries with 13% false positive, giving a likelihood ratio of 8 [2.2–13.5]. Conclusion High levels of sCD163 or CRP are associated with an increased risk of preterm delivery in women with symptoms of delivery. Good prediction of preterm delivery before 34 weeks of gestation was obtained by a combination of preterm prelabour rupture of membranes (PPROM), overweight, relaxin, CRP and sCD163.