title: The diagnostic value of cervicovaginal and serum ferritin levels in midgestation time to predict spontaneous preterm delivery.
abstract: BACKGROUND
  The aim of this study was to determine diagnostic value of cervicovaginal ferretin and serum ferretin levels at midgestation time in predicting preterm delivery in singleton pregnancies.
  
  
  METHODS
  A diagnostic test study through a prospective cohort design was carried out on 300 singleton pregnant women in 2012. A blood sample was obtained from all the patients within 22-24 gestational weeks for laboratory assessment of serum ferretin, and cervicovaginal sample was also taken to assess cervicovaginal ferritin level. Ferritin levels were compared between term and preterm deliveries at 37, 34 and 32 weeks of gestation. Receiver operating characteristics (ROC) curves were plotted to assess the diagnostic test values.
  
  
  RESULTS
  Mean serum ferritin level was 55.38 [standard deviation (SD 23.8)] ng/mL in term deliveries versus a mean of 91.27 (SD 25.2) ng/mL in preterm deliveries, which showed a statistically significant difference (P < 0.001). The ferritin levels in cervicovaginal term delivery group had mean of 11.29 (SD 16.2) ng/mL compared with a mean of 21.95 (SD 10.1) ng/mL among those with preterm delivery before 37 weeks of gestational age(P < 0.001). The cervicovaginal ferritin level had a moderate to good diagnostic value with an area under curve being above 0.8 for all assessments. The serum ferritin level had a moderate to good diagnostic value with an area under curve being above 0.8 for all assessments. In both tests, its diagnostic value was higher for predicting preterm delivery at earlier gestational age.
  
  
  CONCLUSIONS
  The results of this study indicate that high levels of serum and cervicovaginal ferritin in singleton pregnancies may alert the clinician of the risk of preterm delivery. Serum and cervicovaginal ferritin measurement at midgestation may be used as a predictive scale for preterm delivery in singleton pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Broumand
authors.affiliation: Department of Obstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Soudabeh
authors.initials: S
authors.lastname: Saeidkar
authors.affiliation: Department of Obstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Behrouzlak
authors.affiliation: Department of Obstetrics and Gynecology, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Khalkhali
authors.affiliation: Neuroscience Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran ; WHO collaborating center on community safety promotion, Karolinska Institute, Stockholm, Sweden.
authors.forename: Homayoun
authors.initials: H
authors.lastname: Sadeghi-Bazargani
keywords: Cervicovaginal ferritin; ferritin; prematurity; preterm labor
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