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Stewart DR. Commercial immunoassays for human relaxin-2. Mol Cell Endocrinol 2019; 487:94-97. [PMID: 30633956 DOI: 10.1016/j.mce.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 01/29/2023]
Abstract
Several different immunoassays have been used in the commercial pharmaceutical development of serelaxin. These assays have been well validated for submission of GLP preclinical and clinical studies to the FDA and EU regulatory bodies. The requirements for these assays exceed that of most research assays commonly developed in academic research but have been and are currently available to academic researchers. Additionally, many human relaxin immunoassays are commercially available from a variety of vendors. Validation procedures for immunoassays are well understood and documented, however validation of these assays is often lacking or completely absent. The data derived from these assays must be questioned if the investigator does not supply information on the validation of the assay used, either from the supplier or through their own efforts. Many recent papers on determination of serum relaxin in clinical settings have recently been published. The assay used for this determination varies but generally is one of two commercially available. These manuscripts and the assay used is discussed. Direct comparisons of assays are lacking but some general conclusions can be drawn by comparing results from similar studies using different assays. There is disagreement among the results of the concentrations of serum relaxin from the use of different assays that raise questions on assay reliability. The differences in the quality of immunoassays used for detection of serum relaxin should be part of the decisions making process in choosing an assay. While the end user bears the ultimate responsibility to demonstrate the assay is valid for the stated claims, reviewers and editors also share responsibility for quality of published results.
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Affiliation(s)
- Dennis R Stewart
- Molecular Medicine Research Institute, 428 Oakmead Pkwy, Sunnyvale, CA, 94085, USA.
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Pantelis A, Sotiriadis A, Chatzistamatiou K, Pratilas G, Dinas K. Serum relaxin and cervical length for prediction of spontaneous preterm birth in second-trimester symptomatic women. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:763-768. [PMID: 29205573 DOI: 10.1002/uog.18972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/27/2017] [Accepted: 10/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE 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). METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- A Pantelis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece
| | - A Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece
| | - K Chatzistamatiou
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece
| | - G Pratilas
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece
| | - K Dinas
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece
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Hou Q, Jiang C, Huang Y, Ye J, Yang X. Is maternal serum relaxin associated with preterm delivery in Chinese pregnant women? A meta-analysis. J Matern Fetal Neonatal Med 2018; 32:3357-3366. [PMID: 29788816 DOI: 10.1080/14767058.2018.1463983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Objective: A meta-analysis was performed to study the relationship between serum relaxin and preterm delivery in women with singleton pregnancies without estrogen stimulation. Methods: Cohort and case-control studies were identified through searching databases (PubMed, Embase, Ovid, CBM, Wan fang, VIP, and CNKI). We carried out a continuous variable meta-analysis. The outcome was preterm delivery (gestation age <37 weeks). Results: Fifteen studies were included, involving 1607 women with a singleton pregnancy. The pooled standard mean deviation (SMD) of 15 studies was 0.559 (95%CI: 0.002-1.196) and the heterogeneity was 96.6%. To reduce the heterogeneity, we chose random effects model and made subgroup analysis according to gestational age at sample testing (<18 weeks and ≥18 weeks) and race of included pregnant women. The pooled SMD of gestational age at sample testing ≥18 weeks and Chinese were 1.19 (95%CI: 0.63-1.75) and 1.61 (95%CI: 0.82-2.41) and the heterogeneity values (measured by I2) were 93.5% and 76.5%, respectively. Conclusions: Elevated maternal serum relaxin of later than 18 weeks of gestational age is associated with singleton preterm birth in Chinese women. It might be an important information to prevent singleton preterm delivery in Chinese women. What's already known about this topic? Previous reports reveal that there is a relationship between elevated maternal serum relaxin and preterm birth. However, the included articles contained twin pregnancies and estrogen stimulation, which obviously resulted in higher relaxin concentrations. What does this study add?
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Affiliation(s)
- Qingzhi Hou
- a Department of Occupational Health and Environmental Health , School of Public Health of Guangxi Medical University , Nanning , China.,b Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , China
| | - Chao Jiang
- a Department of Occupational Health and Environmental Health , School of Public Health of Guangxi Medical University , Nanning , China.,b Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , China
| | - Yaling Huang
- a Department of Occupational Health and Environmental Health , School of Public Health of Guangxi Medical University , Nanning , China.,b Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , China
| | - Juan Ye
- a Department of Occupational Health and Environmental Health , School of Public Health of Guangxi Medical University , Nanning , China.,b Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , China
| | - Xiaobo Yang
- a Department of Occupational Health and Environmental Health , School of Public Health of Guangxi Medical University , Nanning , China.,b Center for Genomic and Personalized Medicine , Guangxi Medical University , Nanning , China
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Sundtoft I, Langhoff-Roos J, Sandager P, Sommer S, Uldbjerg N. Cervical collagen is reduced in non-pregnant women with a history of cervical insufficiency and a short cervix. Acta Obstet Gynecol Scand 2017; 96:984-990. [PMID: 28374904 DOI: 10.1111/aogs.13143] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 03/29/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second trimester of pregnancy. MATERIAL AND METHODS In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (<5th percentile) and 10 women with a history of a long cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. RESULTS Women with cervical insufficiency had lower collagen concentrations (63.5 ± 5.1%; mean ± SD) compared with controls (68.2 ± 5.4%; p = 0.0004); area under the ROC curve 0.73 (95% CI 0.62-0.84). A cut-off value at 67.6% collagen resulted in a positive likelihood ratio of 3.2, a sensitivity of 60%, and a specificity of 81%. Also, women with a short cervix in the second trimester had lower collagen concentrations in a non-pregnant state (62.1% ± 4.9%) compared with women with a long cervix (67.8% ± 5.0%; p = 0.02). CONCLUSIONS Both cervical insufficiency and a short cervix in the second trimester of pregnancy are associated with low cervical collagen concentrations in a non-pregnant state more than one year after pregnancy.
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Affiliation(s)
- Iben Sundtoft
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Langhoff-Roos
- Clinic of Obstetrics and Gynecology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Puk Sandager
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Steffen Sommer
- Department of Obstetrics and Gynecology, The Regional Hospital Horsens, Horsens, Denmark
| | - Niels Uldbjerg
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
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Weiss G, Teichman S, Stewart D, Nader D, Wood S, Breining P, Unemori E. Recombinant human relaxin versus placebo for cervical ripening: a double-blind randomised trial in pregnant women scheduled for induction of labour. BMC Pregnancy Childbirth 2016; 16:260. [PMID: 27596360 PMCID: PMC5011832 DOI: 10.1186/s12884-016-1046-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 07/08/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Nonclinical studies indicate that the hormone relaxin is a good candidate for a safe cervical ripening agent that does not cause uterine contractions. METHODS This Phase II study (conducted November 2, 2005-October 20, 2006) was a randomised, double blind, placebo controlled trial testing 24-h intravenous infusion of serelaxin (recombinant human relaxin) or placebo for cervical ripening in 72 healthy, primiparous women. Eligible subjects had a singleton pregnancy ≥40 weeks, were planned for elective induction, had vertex presentation of the fetus, intact membranes and a Bishop score at screening ≤4. In Part A of the study, safety evaluation of three escalating doses of serelaxin (7.5, 25 or 75 μg/kg/day) or placebo was performed in 22 subjects admitted to the hospital 24 h prior to scheduled induction (n = 7, 4, 4, and 7 subjects, respectively). The highest safe dose from Part A and placebo were then tested in Part B for safety and cervical ripening (n = 25 subjects/arm). Planned randomisation ratio was of 4:2 (serelaxin:placebo) for each dose group in Part A and 1:1 for Part B. For analysis, subjects in Part B were pooled with those receiving the same dose in Part A and all subjects receiving placebo were pooled. The primary efficacy endpoint was change from baseline in Bishop score at 6, 12 and 24 h or end of study drug administration. Maternal safety evaluations included adverse events and vital signs through 4 weeks. Fetal assessments included serial heart rate monitoring and nonstress testing. Neonatal assessments included Apgar scores, NICU admissions, and adverse events through 4 weeks. RESULTS Overall, 74 subjects were randomized and 72 were treated. There were no significant differences between the groups receiving the highest safe dose of serelaxin (75 μg/kg/day) and placebo in the primary or secondary efficacy endpoints. Changes from baseline in Bishop score at 24 h were 4.19 ± 1.9 and 3.26 ± 2.26 in the pooled placebo and serelaxin groups, respectively (p = 0.2507). Serelaxin was well tolerated and no anti-serelaxin antibodies were detected in either subjects or neonates. CONCLUSION Serelaxin infusion at the end of pregnancy was well tolerated but did not advance cervical ripening. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT00259103 (15 November 2005).
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Affiliation(s)
- Gerson Weiss
- Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, 07101, USA.
| | - Sam Teichman
- At the time of study conduct, an employee of Corthera, Inc. (formerly BAS Medical), 1660 South Amphlett Blvd., San Mateo, CA, 94402, USA
| | - Dennis Stewart
- At the time of study conduct, an employee of Corthera, Inc. (formerly BAS Medical), 1660 South Amphlett Blvd., San Mateo, CA, 94402, USA
| | - David Nader
- At the time of study conduct, an employee of Corthera, Inc. (formerly BAS Medical), 1660 South Amphlett Blvd., San Mateo, CA, 94402, USA
| | - Susan Wood
- At the time of study conduct, an employee of Corthera, Inc. (formerly BAS Medical), 1660 South Amphlett Blvd., San Mateo, CA, 94402, USA
| | - Peter Breining
- At the time of study conduct, an employee of Corthera, Inc. (formerly BAS Medical), 1660 South Amphlett Blvd., San Mateo, CA, 94402, USA
| | - Elaine Unemori
- At the time of study conduct, an employee of Corthera, Inc. (formerly BAS Medical), 1660 South Amphlett Blvd., San Mateo, CA, 94402, USA
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Thorell E, Goldsmith L, Weiss G, Kristiansson P. Physical fitness, serum relaxin and duration of gestation. BMC Pregnancy Childbirth 2015; 15:168. [PMID: 26272327 PMCID: PMC4536895 DOI: 10.1186/s12884-015-0607-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/04/2015] [Indexed: 11/16/2022] Open
Abstract
Background Women are recommended to perform regular exercise during pregnancy but the impact of physical fitness on duration of gestation and miscarriage is inconsistent. In addition, a dose-response relation between the amount of weekly exercise and increased risk of miscarriage in early pregnancy has been observed. Previous studies have mostly used an epidemiologic method. Larger studies using careful measurement of physical fitness are needed. Besides physical fitness, maternal circulating concentrations of the hormone relaxin have been associated with decreased duration of gestation. Methods A prospective cohort including 20 women with miscarriage and 460 women with spontaneous onset of labour, recruited from maternal health care centres in central Sweden, were examined in early pregnancy regarding estimated absolute peak oxygen uptake (\documentclass[12pt]{minimal}
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\begin{document}$$ \dot{V}{O}_2 $$\end{document}V˙O2peak, est.) by cycle ergometer test, and maternal circulating serum relaxin concentrations. Results Women with miscarriage displayed the highest level of absolute \documentclass[12pt]{minimal}
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\begin{document}$$ \dot{V}{O}_2 $$\end{document}V˙O2peak, est. (2.61 l/min) and the lowest serum relaxin concentrations (640 ng/l). Among women with spontaneous onset of labour, the mean absolute \documentclass[12pt]{minimal}
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\begin{document}$$ \dot{V}{O}_2 $$\end{document}V˙O2peak, est. increased successively from the lowest estimated oxygen uptake of 2.31 l/min among those with preterm birth (n = 28), to an oxygen uptake of 2.49 l/min among women with postterm birth (n = 31). An opposite trend was shown regarding serum relaxin concentrations from women with miscarriage to those with postterm birth. Serum relaxin concentrations, but not absolute \documentclass[12pt]{minimal}
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\begin{document}$$ \dot{V}{O}_2 $$\end{document}V˙O2peak, est. was significantly and independently associated with duration of gestation in women with miscarriages, and absolute \documentclass[12pt]{minimal}
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\begin{document}$$ \dot{V}{O}_2 $$\end{document}V˙O2peak, est., age and multiple pregnancy were independently associated with duration of gestation in women with spontaneous onset of labour. Conclusions Physical fitness appears to be a protective factor of established pregnancies and not significantly involved in the risk of early miscarriage. Additional studies are needed to more clearly define the role of relaxin in miscarriage.
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Affiliation(s)
- Eva Thorell
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, SE-75122, Sweden.
| | - Laura Goldsmith
- Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School of Rutgers University, Newark, NJ, 07103, USA.
| | - Gerson Weiss
- Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School of Rutgers University, Newark, NJ, 07103, USA.
| | - Per Kristiansson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, SE-75122, Sweden.
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Vrachnis N, Grigoriadis C, Siristatidis C, Vlachadis N, Balakitsas N, Mastorakos G, Iliodromiti Z. The Janus face of maternal serum relaxin: a facilitator of birth, might it also induce preterm birth? J Matern Fetal Neonatal Med 2014; 28:2187-91. [PMID: 25363010 DOI: 10.3109/14767058.2014.981804] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Preterm birth is a major cause of neonatal morbidity and mortality in the developed world. In order to better understand the pathophysiological pathway of this condition, the role of genetic factors and/or inflammation-associated molecules, as well as of socioeconomic parameters, is therefore under intense investigation. The purpose of this review study was to examine the potential role of maternal serum relaxin levels in the etiology of preterm birth. METHODS Electronic databases (Pubmed, Embase, Cochrane Library) were searched for previously published research studies that investigated the biological role of relaxin and the mechanisms in which this hormone is involved during pregnancy and labor. RESULTS It is evident that while relaxin is an essential endometrial/decidual angiogentic factor playing a vital role in maternal accommodation of pregnancy, elevated levels of this hormone could well be associated with preterm birth. CONCLUSIONS There are strong indications that maternal serum hyperrelaxinemia correlates with an increased risk of preterm birth.
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Affiliation(s)
- Nikolaos Vrachnis
- a 2nd Department of Obstetrics and Gynecology , Medical School, Aretaieion Hospital and
| | | | - Charalampos Siristatidis
- b 3rd Department of Obstetrics and Gynecology , Medical School, Attiko Hospital, University of Athens , Athens , Greece
| | - Nikolaos Vlachadis
- a 2nd Department of Obstetrics and Gynecology , Medical School, Aretaieion Hospital and
| | - Nikolaos Balakitsas
- a 2nd Department of Obstetrics and Gynecology , Medical School, Aretaieion Hospital and
| | - George Mastorakos
- a 2nd Department of Obstetrics and Gynecology , Medical School, Aretaieion Hospital and
| | - Zoe Iliodromiti
- a 2nd Department of Obstetrics and Gynecology , Medical School, Aretaieion Hospital and
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Hansen AT, Sandager P, Uldbjerg N, Hvas AM. Copeptin is not a useful biomarker for small-for-gestational-age: a case control study. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 74:687-92. [PMID: 25120188 DOI: 10.3109/00365513.2014.940375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate copeptin as a biomarker for small-for-gestational-age. METHODS We conducted a nested case-control study on maternal copeptin levels measured in gestational week 12 and 19 and risk of small-for-gestational age. Cases were defined as pregnant women who delivered a small-for-gestational-age infant. Small-for-gestational age was defined as a birth weight - 22% or less than expected according to gestational age (n = 39). Controls were pregnant women who delivered a normal-weight infant (n = 119). The copeptin ultrasensitive Kryptor kit (BRAHMS) was used to determine copeptin in maternal serum. We established reference ranges for copeptin by 95% prediction intervals with 90% confidence intervals. Paired and unpaired t-tests were performed to test the null-hypothesis of no difference in copeptin levels within and between the groups. RESULTS The reference intervals for copeptin in normal pregnancies were 1.24-5.51 pmol/L (90% confidence intervals on upper and lower limit were 1.13-1.37 and 5.00-6.08 pmol/L) at gestational week 12, and 1.30-5.09 pmol/L (90% confidence intervals were 1.19-1.42 and 4.65-5.57 pmol/L) at gestational week 19. Copeptin levels decreased from week 12-19 in cases (p = 0.02), whereas no change was observed in controls (p = 0.61). We found no difference in copeptin levels in cases compared to controls in gestational week 12 (p = 0.10) and week 19 (p = 0.81). CONCLUSION The present study could not demonstrate copeptin as a novel biomarker for small-for-gestational-age.
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Affiliation(s)
- Anette T Hansen
- Department of Clinical Biochemistry, Aarhus University Hospital , Aarhus , Denmark
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Anand-Ivell R, Dai Y, Ivell R. Neohormones as biomarkers of reproductive health. Fertil Steril 2013; 99:1153-60. [DOI: 10.1016/j.fertnstert.2012.12.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 12/14/2012] [Accepted: 12/14/2012] [Indexed: 12/13/2022]
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HEE LENE. Likelihood ratios for the prediction of preterm delivery with biomarkers. Acta Obstet Gynecol Scand 2011; 90:1189-99. [DOI: 10.1111/j.1600-0412.2011.01187.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Conde-Agudelo A, Papageorghiou AT, Kennedy SH, Villar J. Novel biomarkers for the prediction of the spontaneous preterm birth phenotype: a systematic review and meta-analysis. BJOG 2011; 118:1042-54. [PMID: 21401853 DOI: 10.1111/j.1471-0528.2011.02923.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Being able to predict preterm birth is important, as it may allow a high-risk population to be selected for future interventional studies and help in understanding the pathways that lead to preterm birth. OBJECTIVE To investigate the accuracy of novel biomarkers to predict spontaneous preterm birth in women with singleton pregnancies and no symptoms of preterm labour. SEARCH STRATEGY Electronic searches in PubMed, Embase, Cinahl, Lilacs, and Medion, references of retrieved articles, and conference proceedings. No language restrictions were applied. SELECTION CRITERIA Observational studies that evaluated the accuracy of biomarkers proposed in the last decade to predict spontaneous preterm birth in asymptomatic women. We excluded studies in which biomarkers were evaluated in women with preterm labour. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data on study characteristics, quality, and accuracy. Data were arranged in 2 × 2 contingency tables and synthesised separately for spontaneous preterm birth before 32, 34, and 37 weeks of gestation. We used bivariate meta-analysis to estimate pooled sensitivities and specificities, and calculated likelihood ratios (LRs). MAIN RESULTS A total of 72 studies, including 89,786 women and evaluating 30 novel biomarkers, met the inclusion criteria. Only three biomarkers (proteome profile and prolactin in cervicovaginal fluid, and matrix metalloproteinase-8 in amniotic fluid) had positive LRs > 10. However, each of these biomarkers was evaluated in only one small study. Four biomarkers had a moderate predictive accuracy (interleukin-6 and angiogenin, in amniotic fluid; human chorionic gonadotrophin and phosphorylated insulin-like growth factor binding protein-1, in cervicovaginal fluid). The remaining biomarkers had low predictive accuracies. CONCLUSIONS None of the biomarkers evaluated in this review meet the criteria to be considered a clinically useful test to predict spontaneous preterm birth. Further large, prospective cohort studies are needed to evaluate promising biomarkers such as a proteome profile in cervicovaginal fluid.
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Affiliation(s)
- A Conde-Agudelo
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, USA
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HEE LENE, KIRKEGAARD IDA, VOGEL IDA, THORSEN POUL, SKOGSTRAND KRISTIN, HOUGAARD DAVIDM, ULDBJERG NIELS, SANDAGER PUK. Low serum interleukin-17 is associated with preterm delivery. Acta Obstet Gynecol Scand 2010; 90:92-6. [DOI: 10.1111/j.1600-0412.2010.01017.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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