New biomarkers for the prediction of spontaneous preterm labour in symptomatic pregnant women: a comparison with fetal fibronectin

Liong, S., Di Quinzio, M. K. W., Fleming, G., Permezel, M., Rice, G. E. and Georgiou, H. M. (2015) New biomarkers for the prediction of spontaneous preterm labour in symptomatic pregnant women: a comparison with fetal fibronectin. BJOG: An International Journal of Obstetrics and Gynaecology, 122 3: 370-379. doi:10.1111/1471-0528.12993


Author Liong, S.
Di Quinzio, M. K. W.
Fleming, G.
Permezel, M.
Rice, G. E.
Georgiou, H. M.
Title New biomarkers for the prediction of spontaneous preterm labour in symptomatic pregnant women: a comparison with fetal fibronectin
Journal name BJOG: An International Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 1471-0528
1470-0328
Publication date 2015-02-01
Year available 2014
Sub-type Article (original research)
DOI 10.1111/1471-0528.12993
Open Access Status Not yet assessed
Volume 122
Issue 3
Start page 370
End page 379
Total pages 10
Place of publication Chichester, West Sussex United Kingdom
Publisher Blackwell Publishing
Language eng
Abstract Objective To identify cervicovaginal fluid (CVF) biomarkers predictive of spontaneous preterm birth in women with symptoms of preterm labour.
Formatted abstract
Objective

To identify cervicovaginal fluid (CVF) biomarkers predictive of spontaneous preterm birth in women with symptoms of preterm labour.

Design

Retrospective cohort study.

Setting

Melbourne, Australia.

Population

Women with a singleton pregnancy admitted to the Emergency Department between 22 and 36 weeks of gestation presenting with symptoms of preterm labour.

Methods

Two-dimensional electrophoresis was used to analyse the CVF proteome. Validation of putative biomarkers was performed using enzyme-linked immunosorbent assay (ELISA) in an independent cohort. Optimal concentration thresholds of putative biomarkers were determined and the predictive efficacy for preterm birth was compared with that of fetal fibronectin.

Main outcome measures

Prediction of spontaneous preterm labour within 7 days.

Results

Differentially expressed proteins were identified by proteomic analysis in women presenting with ‘threatened’ preterm labour without cervical change who subsequently delivered preterm (n = 12 women). ELISA validation using an independent cohort (n = 129 women) found albumin and vitamin D-binding protein (VDBP) to be significantly altered between women who subsequently experienced preterm birth and those who delivered at term. Prediction of preterm delivery within 7 days using a dual biomarker model (albumin/VDBP) provided 66.7% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 96.7% negative predictive value (NPV), compared with fetal fibronectin yielding 66.7, 87.9, 36.4 and 96.2%, respectively (n = 64). Using the maximum number of screened samples, the predictive utility of albumin/VDBP yielded a sensitivity of 77.8%, specificity and PPV of 100% and NPV of 98.0% (n = 109).

Conclusions

The dual biomarker model of albumin/VDBP is more efficacious than fetal fibronectin in predicting spontaneous preterm delivery in symptomatic women within 7 days. A clinical diagnostic trial is required to test this model on a larger population to confirm these findings and to further refine the predictive values.
Keyword Biomarkers
Cervicovaginal fluid
Pregnancy
Preterm labour
Proteomics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 24 July 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2015 Collection
 
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