Plasma CRH measurement at 16 to 20 weeks' gestation does not predict preterm delivery in women at high-risk for preterm delivery
Plasma CRH measurement at 16 to 20 weeks' gestation does not predict preterm delivery in women at high-risk for preterm delivery
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DOI：
10.1016/j.ajog.2005.06.036
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发表时间：
2005-09-01
影响因子：
9.8
通讯作者：
Gabbe, S
中科院分区：
文献类型：
--
作者：
Sibai, B;Meis, PJ;Gabbe, S
目的：本研究的目的是检查一个单一的中期妊娠血浆促肾上腺皮质激素释放激素测量的效用，作为早产高危妇女早产的标志物研究设计：这是一个多中心安慰剂对照试验的数据分析，旨在评估17 α-羟孕酮己酸（17 P）在预防复发性早产中的作用。有记录的先前在< 37周时自发性早产史的妇女被招募（16-20周），并以2：1的比例随机分配到每周注射17 P或匹配的安慰剂。在19个中心中的11个中心登记的170名患者（113名分配17 P和57名安慰剂）中在治疗前收集血液。比较早产儿和足月儿血浆促肾上腺皮质激素释放激素水平。结果：在这170名患者的队列中，早产的总发生率在< 37周时为35.9%（孕酮31.9%，安慰剂43.9%），在< 35周时为19.4%（18.6%对21.9%）。1%）。在≥ 37周分娩的患者中，促肾上腺皮质激素释放激素的中位水平相似< 37 weeks and those delivering >（0.39 ng/mL vs 0.37 ng/mL，P = 0.08）。此外，在≥ 35周分娩的患者中，促肾上腺皮质激素释放激素水平无差异< 35 weeks or >（0.36 vs 0.38，P = 0.90）。此外，在安慰剂组中，在< 37 or >≥ 37周（0.40 vs 0.41，P = 0.72）和< 35 or >≥ 35周（P = 0.64）分娩的患者中促肾上腺皮质激素释放激素水平没有差异。结论：在妊娠16至20周时单一测量促肾上腺皮质激素释放激素不是该并发症高风险患者复发性早产的良好生物标志物。(C)2005 Mosby，Inc. All rights reserved.
Objective: The purpose of this study was to examine the utility of a single second- trimester plasma corticotropin-relasing hormone measurement as a marker for preterm delivery in women at high risk for preterm delivery.Study design: This is an analysis of data from a multicenter placebo-con trolled trial designed to evaluate the role of 17 alpha hydroxyprogesterone caproate (17P) in the prevention of recurrent preterm birth. Women with a documented history of a previous spontaneous preterm birth at < 37 weeks were enrolled (16-20 wks) and randomly assigned in a 2 to I ratio to weekly injections of 17P or matching placebo. Blood was collected before treatment in 170 patients (113 assigned 17P and 57 placebo) who were enrolled at I I of the 19 centers. Plasma levels of corticotropin-releasing hormone were compared between those who delivered preterm and those delivering at term. Data were analyzed using the Wilcoxon rank-sum test.Results: The overall rates of preterm birth in this cohort of 170 patients were 35.9% at < 37 weeks (31.9% progesterone, 43.9% placebo), and 19.4% at < 35 weeks (18.6% vs 2 1. 1 %). The median levels of corticotropin-releasing hormone were similar between those delivering at < 37 weeks and those delivering >= 37 weeks (0.39 ng/mL vs 0.37 ng/mL, P = .08). In addition, there were no differences in corticotropin-releasing hormone levels among those who delivered at < 35 weeks or >= 35 weeks (0.36 vs 0.38, P =.90). Moreover, there were no differences in corticotropin-releasing hormone levels among those in the placebo group who delivered at < 37 or >= 37 weeks (0.40 vs 0.41, P = .72) and at < 35 or >= 35 weeks (P = .64).Conclusion: A single measurement of corticotropin- releasing hormone at 16 to 20 weeks' gestation is not a good biomarker for recurrent preterm delivery in patients at high risk for this complication. (C) 2005 Mosby, Inc. All rights reserved.