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Angiogenin: a marker for preterm delivery in midtrimester amniotic fluid
C Y Spong1, A Ghidini, D M Sherer
1Perinatal Research Branch, National Institute of Child Health and Human Development, Washington, D.C., USA.
American Journal of Obstetrics and Gynecology
|February 1, 1997
Summary
Elevated midtrimester amniotic fluid angiogenin levels may predict preterm delivery. This suggests early intrauterine ischemia and inflammation contribute to preterm birth risk.
Area of Science:
- Reproductive Biology
- Maternal-Fetal Medicine
- Biochemistry
Background:
- Placental ischemia is a suspected cause of preterm delivery.
- Neovascularization, induced by angiogenin, is a response to ischemic damage.
Purpose of the Study:
- To investigate if midtrimester amniotic fluid angiogenin levels are elevated in patients who deliver preterm.
- To assess angiogenin as a potential biomarker for preterm delivery risk.
Main Methods:
- A case-control study involving singleton gestations undergoing midtrimester amniocentesis.
- Amniotic fluid angiogenin levels were measured via immunoassay.
- Statistical analysis included natural log transformation and receiver-operator characteristic curve analysis.
Main Results:
- Amniotic fluid angiogenin levels were significantly higher in patients delivering preterm compared to controls (p = 0.002).
- The association remained significant after excluding small-for-gestational-age neonates (p = 0.02).
- An angiogenin cutoff of 31.0 ng/ml predicted preterm delivery with 45.5% sensitivity and 91.0% specificity (odds ratio 6.0).
Conclusions:
- Elevated midtrimester amniotic fluid angiogenin levels are associated with preterm delivery.
- Findings support the role of intrauterine ischemia and inflammation in preterm birth.
- These risk factors may be detectable early in the midtrimester.