Vogel Ida, Grove Jakob, Thorsen Poul, Moestrup Søren K, Uldbjerg Niels, Møller Holger Jon
NANEA, Department of Epidemiology and Social Medicine, Aarhus University, Denmark.
BJOG. 2005 Jun;112(6):737-42. doi: 10.1111/j.1471-0528.2005.00557.x.
To evaluate whether soluble CD163 (sCD163) and C-reactive protein (CRP) can predict spontaneous preterm delivery in women with symptoms of preterm delivery.
Prospective cohort study. Setting Labour ward at a tertiary university hospital.
Ninety-three women with symptoms of preterm delivery before 34 weeks of gestation.
sCD163 and CRP were individually examined as predictors of preterm delivery. A model for prediction of preterm delivery was established using exact logistic regression for risk factors individually associated with preterm delivery.
Gestational age at delivery.
In women with symptoms of preterm delivery, median sCD163 and CRP levels were significantly higher statistically in women delivering preterm (3.4 mg/L, and 62 nmol/L) compared with the women delivering at term (2.7 mg/L, and <48 nmol/L, Mann-Whitney U test, P < 0.01 and P < 0.001) for sCD163 and CRP, respectively. sCD163 above 5 mg/L was associated with an increased risk of preterm delivery (crude OR = 10, [95% CI 1.3-466], adjusted OR = 27, [0.7-infinity]). CRP above 47 mg/L was associated with an increased risk of preterm delivery (crude OR = 5 [1.8-14], adjusted OR = 5 [1.04-31]). Likelihood ratio of a positive test was 8.6 [2.8-14] and 2.8 [0-6.2] for sCD163 and CRP, respectively. The logistic regression model was able to predict 85% of preterm deliveries with 13% false positive, giving a likelihood ratio of 8 [2.2-13.5].
High levels of sCD163 or CRP are associated with an increased risk of preterm delivery in women with symptoms of delivery. Good prediction of preterm delivery before 34 weeks of gestation was obtained by a combination of preterm prelabour rupture of membranes (PPROM), overweight, relaxin, CRP and sCD163.
评估可溶性CD163（sCD163）和C反应蛋白（CRP）能否预测有早产症状的女性发生自然早产。
前瞻性队列研究。地点为一所三级大学医院的产房。
93名在妊娠34周前有早产症状的女性。
分别检测sCD163和CRP作为早产的预测指标。使用精确逻辑回归分析与早产单独相关的危险因素，建立早产预测模型。
分娩时的孕周。
有早产症状的女性中，早产女性的sCD163中位数和CRP水平在统计学上显著高于足月分娩女性（sCD163分别为3.4mg/L和2.7mg/L，CRP分别为62nmol/L和<48nmol/L，Mann-Whitney U检验，sCD163的P<0.01，CRP的P<0.001）。sCD163高于5mg/L与早产风险增加相关（粗OR=10，[95%CI 1.3-466]，调整后OR=27，[0.7-无穷大]）。CRP高于47mg/L与早产风险增加相关（粗OR=5[1.8-14]，调整后OR=5[1.04-31]）。sCD163和CRP的阳性检测似然比分别为8.6[2.8-14]和2.8[0-6.2]。逻辑回归模型能够预测85%的早产，假阳性率为13%，似然比为8[2.2-13.5]。
sCD163或CRP水平升高与有分娩症状的女性早产风险增加相关。通过联合胎膜早破（PPROM）、超重、松弛素、CRP和sCD163，可对妊娠34周前的早产进行良好预测。
