Beta-human chorionic gonadotropin in cervicovaginal secretions and preterm delivery.
OBJECTIVE
To determine whether concentrations of beta-HCG in cervicovaginal secretions could predict spontaneous preterm birth (SPB) in asymptomatic high risk pregnancies.


METHODS
A cohort study was undertaken with cervicovaginal samples collected from 540 pregnant women between 20 to 28 weeks of gestation. Levels of beta-HCG were measured by ELISA test.


RESULTS
There was 3.2-fold increase in cervicovaginal beta-HCG concentrations among patients with SPB vs. term delivery. A single cervicovaginal beta-HCG > 77.8 mIU/ml, between 20 and 28 weeks' gestation, identified patients with subsequent SPB vs. term delivery with sensitivity of 87.5% (95% CI: 47.4-97.9) and a specificity of 97% (95% CI: 86.5-99.4) with positive and negative predictive values of 88.5% and 98%, respectively. Multiple logistic regression indicates that cervicovaginal beta-HCG level > 77.8 mIU/ml was an independent predictor of SPB (adjusted odds ratio 19.97, 95% CI: 10.65-37.45).


CONCLUSIONS
Cervicovaginal beta-HCG is a sensitive and specific predictor of patients with subsequent preterm delivery.
Department of Obstetrics and Gynecology, Shahed University, Faculty of Medicine, Tehran, Iran.
A
A
Garshasbi
T
T
Ghazanfari
S
S
Faghih Zadeh
D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000737:chemistry / Q000378:metabolism*; D006063:Chorionic Gonadotropin / Q000032:analysis*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000175:diagnosis*; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014621:Vagina / Q000737:chemistry / Q000378:metabolism*
D006063:Chorionic Gonadotropin