title: Serum markers for prediction of spontaneous preterm delivery in preterm labour.
abstract: BACKGROUND
  Simple, more sensitive markers to predict spontaneous preterm delivery in preterm labour are needed. The aim of this study is to compare the clinical effectiveness of various serum inflammatory markers and cervix length for prediction of spontaneous preterm delivery.
  
  
  METHODS
  We retrospectively reviewed medical records of 175 patients hospitalized for preterm labour (102 with preterm delivery and 73 with term delivery). For all study subjects, haematological markers and cervix length were recorded on admission. Because neutrophil to lymphocyte ratio (NLR) showed the potential as a diagnostic marker, we designed a combined marker by dividing cervix length by NLR. The diagnostic and prognostic accuracy of the combined marker was analysed using multivariate analyses.
  
  
  RESULTS
  The levels of combined marker (P < 0·001), neutrophil (P < 0·001), lymphocyte (P = 0·02), NLR (P < 0·001), C-reactive protein (P = 0·016) and the cervix length (P < 0·001) in preterm delivery group were significantly different from those of term delivery group. Compared to cervix length or systemic inflammatory markers alone, combined marker showed higher sensitivity (64·2%) and specificity (88·3%) for prediction of preterm delivery. On Cox multivariate analysis, combined marker positive (< 0·29) and short cervix length (< 1·7 cm) were independent poor prognostic factors and combined marker positive was the most powerful prognostic marker for spontaneous preterm delivery (hazard ratio = 5·60, P < 0·001).
  
  
  CONCLUSIONS
  Combined marker could be used as a simple and sensitive parameter for identifying women at risk of spontaneous preterm delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Min-A
authors.initials: MA
authors.lastname: Kim
authors.forename: Byung Seok
authors.initials: BS
authors.lastname: Lee
authors.forename: Yong-Won
authors.initials: YW
authors.lastname: Park
authors.forename: Kyung
authors.initials: K
authors.lastname: Seo
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018836:Inflammation Mediators / Q000097:blood; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein