Prediction of preterm delivery based on maternal plasma urocortin.
BACKGROUND
Preterm birth still remains a significant management problem, and a large number of markers of the disease have been investigated.


OBJECTIVE
We measured plasma levels of urocortin, a neuropeptide expressed by gestational tissues, in women with threatened preterm labor (TPTL) to evaluate whether the measurement may predict preterm delivery (PTD).


METHODS
We studied patients as part of an open observational study.


METHODS
The study was conducted at a tertiary referral center for obstetric care.


METHODS
Eighty-five women with singleton pregnancies between 28 and 34 completed gestational weeks with TPTL participated in the study.


METHODS
Interventions included clinical examination and urocortin measurement.


METHODS
Pregnancy outcome and evaluation of sensitivity, specificity, and predictive values of urocortin as diagnostic test for PTD were measured.


RESULTS
Thirty of 85 patients (35.3%) had PTD: 23 of 30 delivered within 7 d from admission (delivery time interval: 2.91 +/- 1.62 d; gestational weeks at delivery: 32.12 +/- 1.7); the remaining delivered later (delivery time interval: 11.71 +/- 4.27 d; gestational weeks at delivery: 33.5 +/- 2.18). Urocortin was significantly higher in women who delivered preterm (median 131.2 pg/ml, interquartile interval 115.1-139.4 pg/ml) than in those who progressed to term delivery [95.4 (69.9-101.3) pg/ml, P < 0.0001] and still higher in those delivering within 7 d from admission [137.7 (124.8-141.2) pg/ml]. Receiver operating characteristic curve analysis revealed that urocortin at the cutoff of 113.9 pg/ml had sensitivity of 80%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 90% as a marker for PTD.


CONCLUSIONS
Maternal plasma urocortin concentration is increased in patients with TPTL who have PTD, and its measurement may be a promising new biochemical marker of PTD.
Florio
Pasquale
P
Department of Pediatrics, Obstetrics, and Reproductive Medicine, Section of Obstetrics and Gynecology, University of Siena, Policlinico Le Scotte, viale Bracci, 53100 Siena, Italy.
Linton
Elizabeth A
EA
Torricelli
Michela
M
Faldini
Elisa
E
Reis
Fernando M
FM
Imperatore
Alberto
A
Calonaci
Giulia
G
Picciolini
Enrico
E
Petraglia
Felice
F
D000328:Adult; D015415:Biomarkers; D044383:Black People; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis; D006801:Humans; D007752:Obstetric Labor, Premature / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D054832:Urocortins / Q000097:blood*; D044465:White People
D015415:Biomarkers; D054832:Urocortins