title: Maternal serum granulocyte colony-stimulating factor levels and spontaneous preterm birth.
abstract: OBJECTIVE
  Preterm birth (PTB) remains a cause of substantial morbidity with an elusive etiology. Previous studies suggested an association of PTB with elevated serum levels of granulocyte colony-stimulating factor (G-CSF) at 28 weeks gestation. G-CSF, a hematopoietic cytokine, mediates the increase in leukocytes in pregnancy and may play a role in placentation. We evaluated the association between maternal serum G-CSF in the first and second trimesters and PTB.
  
  
  METHODS
  Serum samples collected for the Collaborative Perinatal Project (CPP) from women with normal pregnancy (n = 394) and PTB (n = 31), defined as delivery before 37 weeks gestation, were used to assess G-CSF levels. Linear regression was used to evaluate the relation of G-CSF with gestational age (GA) at birth. Logistic regression, conditional on GA at sample provision, was used to model the association between G-CSF and PTB.
  
  
  RESULTS
  G-CSF was significantly associated with gestational age at birth (p = 0.02). In conditional logistic regression models, G-CSF was significantly associated with PTB, with an adjusted odds ratio (AOR) of 1.52 (95% confidence interval [CI] 1.07, 2.16) per standard deviation (SD) increase.
  
  
  CONCLUSIONS
  Acute effects of G-CSF on PTB have been suggested. In our study we observed an association of higher serum G-CSF levels early in the second trimester with PTB, suggesting PTB as the culmination process beginning early in, if not before, pregnancy.
authors.affiliation: Epidemiology Branch, DESPR, NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland. bwhitcomb@schoolph.umass.edu
authors.forename: Brian W
authors.initials: BW
authors.lastname: Whitcomb
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Luo
authors.forename: Nasser
authors.initials: N
authors.lastname: Chegini
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D036861:Delivery, Obstetric; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005865:Gestational Age; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000175:diagnosis; D011247:Pregnancy / Q000097:blood*; D011262:Pregnancy Trimester, Second / Q000097:blood*; D047928:Premature Birth / Q000097:blood* / Q000175:diagnosis; D044967:Serum; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016179:Granulocyte Colony-Stimulating Factor