title: Association of early-preterm birth with abnormal levels of routinely collected first- and second-trimester biomarkers.
abstract: OBJECTIVE
  The purpose of this study was to examine the relationship between typically measured prenatal screening biomarkers and early-preterm birth in euploid pregnancies.
  
  
  METHODS
  The study included 345 early-preterm cases (<30 weeks of gestation) and 1725 control subjects who were drawn from a population-based sample of California pregnancies who had both first- and second-trimester screening results. Logistic regression analyses were used to compare patterns of biomarkers in cases and control subjects and to develop predictive models. Replicability of the biomarker early-preterm relationships that was revealed by the models was evaluated by examination of the frequency and associated adjusted relative risks (RRs) for early-preterm birth and for preterm birth in general (<37 weeks of gestation) in pregnancies with identified abnormal markers compared with pregnancies without these markers in a subsequent independent California cohort of screened pregnancies (n = 76,588).
  
  
  RESULTS
  The final model for early-preterm birth included first-trimester pregnancy-associated plasma protein A in the ≤5th percentile, second-trimester alpha-fetoprotein in the ≥95th percentile, and second-trimester inhibin in the ≥95th percentile (odds ratios, 2.3-3.6). In general, pregnancies in the subsequent cohort with a biomarker pattern that were found to be associated with early-preterm delivery in the first sample were at an increased risk for early-preterm birth and preterm birth in general (<37 weeks of gestation; adjusted RR, 1.6-27.4). Pregnancies with ≥2 biomarker abnormalities were at particularly increased risk (adjusted RR, 3.6-27.4).
  
  
  CONCLUSIONS
  When considered across cohorts and in combination, abnormalities in routinely collected biomarkers reveal predictable risks for early-preterm birth.
authors: Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA. Laura.Jelliffe@cdph.ca.gov
authors: Laura L
authors: LL
authors: Jelliffe-Pawlowski
authors: Gary M
authors: GM
authors: Shaw
authors: Robert J
authors: RJ
authors: Currier
authors: David K
authors: DK
authors: Stevenson
authors: Rebecca J
authors: RJ
authors: Baer
authors: Hugh M
authors: HM
authors: O'Brodovich
authors: Jeffrey B
authors: JB
authors: Gould
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002140:California; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D047928:Premature Birth / Q000097:blood*; D011296:Prenatal Diagnosis; D012306:Risk; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D000509:alpha-Fetoproteins; D011266:Pregnancy-Associated Plasma Protein-A
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