Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece.
Ultrasound Obstet Gynecol. 2018 Dec;52(6):763-768. doi: 10.1002/uog.18972. Epub 2018 Nov 9.
To investigate whether serum relaxin level is associated with preterm birth in symptomatic women, either as a standalone test or in the context of a combined model of serum relaxin and cervical length (CL).
This was a case-control study of women with a singleton pregnancy who presented between 24 + 0 and 26 + 6 weeks' gestation with threatened preterm labor and intact membranes. CL, full blood count, C-reactive protein level and maternal demographics were recorded at presentation, and blood samples were taken for relaxin measurement. Parameters were compared between women who delivered preterm (before 37 weeks) (n = 46) and those delivering at term (n = 66). Logistic regression with receiver-operating characteristics (ROC) curve analysis was used to assess significant predictors for birth before 37 and before 34 weeks.
Women delivering before 37 weeks had higher mean serum relaxin levels and lower mean CL than those delivering at term (P < 0.0001). Relaxin alone had 63% (95% CI, 49-75%) sensitivity for birth before 37 weeks and 61% (95% CI, 47-74%) for birth before 34 weeks, at a 10% false-positive rate (FPR). Serum relaxin levels did not correlate with CL; a combined model of the two predictors had an area under the ROC curve of 0.895 (95%CI, 0.835-0.954) for the prediction of birth before 37 weeks and 0.869 (95% CI, 0.802-0.937) for birth before 34 weeks (n = 44). Serum relaxin > 1010 pg/mL had 58% sensitivity for prediction of preterm birth in women with a CL > 15 mm, at a 10% FPR.
High serum relaxin level is associated with an increased risk of preterm birth in second-trimester symptomatic women with intact membranes. A combination of serum relaxin and CL increases predictive accuracy for preterm birth. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
探讨在有症状的孕妇中，血清松弛素水平是否与早产有关，无论是作为单独的检测手段，还是在血清松弛素与宫颈长度（CL）联合模型中。
这是一项病例对照研究，纳入了在 24+0 至 26+6 孕周之间出现早产先兆且胎膜完整的单胎妊娠孕妇。在就诊时记录 CL、全血细胞计数、C 反应蛋白水平和产妇人口统计学特征，并采集血液样本检测松弛素水平。比较了在 37 周前（n=46）和 37 周后（n=66）分娩的孕妇的参数。采用逻辑回归和接收者操作特征（ROC）曲线分析来评估预测 37 周前和 34 周前分娩的显著指标。
与足月分娩的孕妇相比，在 37 周前分娩的孕妇血清松弛素水平更高，平均 CL 更低（P<0.0001）。单独使用松弛素预测 37 周前分娩的敏感性为 63%（95%CI，49-75%），预测 34 周前分娩的敏感性为 61%（95%CI，47-74%），假阳性率（FPR）为 10%。血清松弛素水平与 CL 不相关；两种预测指标的联合模型预测 37 周前分娩的 ROC 曲线下面积为 0.895（95%CI，0.835-0.954），预测 34 周前分娩的面积为 0.869（95%CI，0.802-0.937）（n=44）。在 CL>15 mm 的孕妇中，血清松弛素>1010 pg/mL 预测早产的敏感性为 58%，FPR 为 10%。
在有症状且胎膜完整的孕中期妇女中，高血清松弛素水平与早产风险增加有关。血清松弛素与 CL 的联合可提高早产预测的准确性。版权所有©2017 ISUOG。由 John Wiley & Sons Ltd 出版。
