title: Mid-trimester maternal serum and amniotic fluid biomarkers for the prediction of preterm delivery and intrauterine growth retardation.
abstract: OBJECTIVE
  Our purpose was to evaluate the predictive value of maternal serum and amniotic fluid biomarkers that were obtained at the time of genetic amniocentesis for preterm delivery and intrauterine growth retardation (IUGR).
  
  
  METHODS
  A prospective cohort analysis was conducted in 107 singleton pregnancies that underwent amniocentesis at 16-22 weeks according to standard genetic indications. Maternal blood and amniotic fluid obtained from genetic amniocentesis were tested for glucose, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), ceruloplasmin, ferritin, high-sensitivity C-reactive protein and interleukin-6 (IL-6). Ninety-four pregnancies were followed until delivery.
  
  
  RESULTS
  Of the 94 patients, 16 (18.1%) delivered before 37 weeks and seven (7.5%) delivered a baby below the 10th percentile for gestational age. Amniotic fluid glucose levels were significantly lower in patients with preterm delivery than term deliveries (P = 0.01). Median amniotic fluid ferritin and IL-6 levels and mean amniotic fluid ALP levels were higher in the preterm group but this difference did not reach statistical significance. Mean maternal ALP and LDH levels tended to be insignificantly higher. Only median maternal blood ferritin levels in the IUGR group were found to be higher than patients who were appropriate for gestational age (P = 0.03).
  
  
  CONCLUSIONS
  Low amniotic fluid glucose levels are associated with risk of preterm delivery, whereas high maternal blood ferritin levels increase the risk for IUGR. Although this result is significant and notable, there is not enough clinical evidence to recommend their use as a screening test for preterm delivery and IUGR in routine practice.
authors.affiliation: Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey.
authors.forename: A Seval
authors.initials: AS
authors.lastname: Ozgu-Erdinc
authors.forename: Sabri
authors.initials: S
authors.lastname: Cavkaytar
authors.forename: Ayla
authors.initials: A
authors.lastname: Aktulay
authors.forename: Umran
authors.initials: U
authors.lastname: Buyukkagnici
authors.forename: Salim
authors.initials: S
authors.lastname: Erkaya
authors.forename: Nuri
authors.initials: N
authors.lastname: Danisman
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D000653:Amniotic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002570:Ceruloplasmin / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood; D005317:Fetal Growth Retardation / Q000097:blood*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood*; D047928:Premature Birth / Q000097:blood*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein; D005293:Ferritins; D007770:L-Lactate Dehydrogenase; D002570:Ceruloplasmin; D000469:Alkaline Phosphatase
keywords: amniotic fluid; biomarker; intrauterine growth retardation; mid-trimester; preterm delivery