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Prediction of preterm delivery using changes in serum relaxin in low risk pregnancies
Ida Vogel1, Poul Thorsen, Heidi Holmager Hundborg
1NANEA, Institute for Public Health, Department of Epidemiology, University of Aarhus, Vennelyst Boulevard 6, 8000 Aarhus C, Denmark. iv@soci.au.dk
Objective:
To examine serum relaxin as a predictor of spontaneous preterm delivery.
Study Design:
A prospective study of 2846 women with singleton pregnancies, from which a matched case-control study (84 cases of spontaneous preterm delivery before 37 weeks gestation and 175 controls) and a cohort (84 preterm and 399 term deliveries) were extracted.
Results:
In the women with a subsequent preterm delivery the relaxin level decreased by 0.9% per week as compared to 1.9% per week (t-test, p=0.004) in the women with term deliveries. From the cohort the course of S-relaxin during pregnancy in both preterm and term deliveries were fitted and graphed. S-relaxin level was raised in women who were hormonally stimulated to obtain pregnancy (p=0.0001), and lower in women with pre-pregnancy overweight (BMI> or =25, p=0.01) as well as in women, who had previously been pregnant (p=0.008). A longitudinal adjusted model for the prediction of preterm delivery based on the change in S-relaxin was established.
Conclusions:
S-relaxin levels decrease less rapidly in women who subsequently deliver preterm; this results in elevated S-relaxin levels in the second and the third trimesters.
