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Secretory component of immunoglobulin A in maternal serum and the prediction of preterm delivery
J C Schellenberg1, R A North, R Taylor
1Research Centre in Reproductive Medicine, Department of Obstetrics and Gynaecology, National Women's Hospital, Auckland, New Zealand.
Objective:
Our purpose was to determine whether the secretory component of immunoglobulin A in maternal serum predicts delivery before 34 weeks' gestation.
Study Design:
Primigravid women of an urban population in New Zealand were recruited at booking into a prospective longitudinal nested case control study (n = 1651; after exclusions and withdrawals, n = 1511). Serum was collected at 8 to 12 weeks, 15 to 18 weeks, 21 to 24 weeks, 28 to 30 weeks, and 36 to 38 weeks of gestation and 6 weeks post partum. Concentrations of the secretory component of immunoglobulin A were determined by enzyme-linked immunosorbent assay in all women who were delivered preterm (n = 53) and in controls randomly selected from women delivered at > or =37 weeks' gestation (n = 178).
Results:
Serum concentrations of the secretory component of immunoglobulin A were similar in women delivered at term or preterm throughout pregnancy (n = 21 delivered at <34 weeks and n = 32 at 34 to 36.9 weeks, incidence 3.5%). Receiver-operator characteristic curves showed no discriminating ability of the secretory component of immunoglobulin A. Smokers had 50% higher concentrations than nonsmokers did (p < 0.0001 by analysis of variance).
Conclusion:
The secretory component of immunoglobulin A in maternal serum does not predict preterm delivery in a low-risk population.