Intercellular adhesion molecule-1 (ICAM-1) in cervicovaginal fluid of women presenting with preterm labor: predictive value for preterm delivery.
OBJECTIVE
Clinically useful tests for the prediction and diagnosis of preterm labor and delivery remain to be established. We have hypothesized that soluble intercellular adhesion molecule-1 (sICAM-1) in the cervicovaginal fluid of women with preterm labor may be a useful diagnostic tool.


METHODS
The cervicovaginal fluid of 103 women between 24(0) and 33(6) weeks gestation with preterm contractions and intact membranes was assayed for sICAM-1.


RESULTS
Elevated sICAM-1 concentrations predicted short intervals to delivery (area under receiver operator characteristic (ROC) curves, 0.70-0.72 for delivery within 3, 7 and 10 days), with high specificity. Characteristics for delivery within 3 days at a 3 ng/mL threshold for a positive test were sensitivity 33.3%, specificity 98.9%, and positive and negative predictive values of 75.0% and 93.9%, respectively. Predictive ability was independent of and complementary to that of fetal fibronectin (fFN).


CONCLUSIONS
Measurement of sICAM-1 in cervicovaginal fluid has potential as a predictor of preterm delivery in women with symptoms of preterm labor, particularly in conjunction with fFN testing.
Marvin
K W
KW
Department of Pharmacology and Clinical Pharmacology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand. k.marvin@auckland.ac.nz
Keelan
J A
JA
Coleman
M A
MA
McCowan
L M
LM
Zhou
R L
RL
Mitchell
M D
MD
D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism*; D005260:Female; D005333:Fetus / Q000378:metabolism; D005353:Fibronectins / Q000378:metabolism; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012995:Solubility; D014621:Vagina / Q000378:metabolism*
D005353:Fibronectins; D018799:Intercellular Adhesion Molecule-1