title: Prediction of spontaneous preterm delivery in women with threatened preterm labour: a prospective cohort study of multiple proteins in maternal serum.
abstract: OBJECTIVE
  To analyse whether specific proteins in maternal serum and cervical length, alone or in combination, can predict the likelihood that women with intact membranes with threatened preterm labour will deliver spontaneously within 7 days of sampling.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Sahlgrenska University Hospital, Gothenburg, Sweden.
  
  
  METHODS
  Women at between 22 and 33 weeks of gestation with threatened preterm labour (n = 142) admitted to the Sahlgrenska University Hospital, Gothenburg, Sweden, in 1995-2005.
  
  
  METHODS
  Maternal serum was tested for 27 proteins using multiplex xMAP technology. Individual levels of each protein were compared, and calculations were performed to investigate potential associations between different proteins, cervical length and spontaneous preterm delivery. Receiver operating characteristic curves were used to find the best cut-off values for continuous variables in relation to spontaneous preterm delivery within 7 days of sampling. Prediction models were created based on a stepwise logistic regression using binary variables.
  
  
  METHODS
  Spontaneous preterm delivery within 7 days.
  
  
  RESULTS
  In order to determine the best prediction model, we analysed models of serum proteins alone, cervical length alone, and the combination of serum proteins and cervical length. We found one multivariable combined model through the data analysis that more accurately predicted spontaneous preterm delivery within 7 days. This model was based on serum interleukin-10 (IL-10) levels, serum RANTES levels and cervical length (sensitivity 74%, specificity 87%, positive predictive value 76%, negative predictive value 86%, likelihood ratio 5.8 and area under the curve 0.88).
  
  
  CONCLUSIONS
  A combination of maternal serum proteins and cervical length constituted the best prediction model, and would help determine whether women with threatened preterm labour are likely to deliver within 7 days of measurement.
authors.affiliation: Department of Obstetrics and Gynaecology, Papageorgiou University Hospital, Thessaloniki, Greece. tsiartaspanos@gmail.com
authors.forename: P
authors.initials: P
authors.lastname: Tsiartas
authors.forename: R M
authors.initials: RM
authors.lastname: Holst
authors.forename: U B
authors.initials: UB
authors.lastname: Wennerholm
authors.forename: H
authors.initials: H
authors.lastname: Hagberg
authors.forename: D M
authors.initials: DM
authors.lastname: Hougaard
authors.forename: K
authors.initials: K
authors.lastname: Skogstrand
authors.forename: B D
authors.initials: BD
authors.lastname: Pearce
authors.forename: P
authors.initials: P
authors.lastname: Thorsen
authors.forename: M
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: B
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism*; D054791:Cervical Length Measurement; D018946:Chemokine CCL5 / Q000097:blood; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D016015:Logistic Models; D015999:Multivariate Analysis; D007752:Obstetric Labor, Premature / Q000097:blood; D011247:Pregnancy; D047928:Premature Birth / Q000097:blood / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D018946:Chemokine CCL5; D016753:Interleukin-10