Document Detail

Elevated mid-trimester maternal corticotrophin-releasing hormone levels in pregnancies that delivered before 34 weeks.
MedLine Citation:
PMID:  10519429     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test whether maternal corticotrophin-releasing hormone levels are elevated in the mid- trimester for those women who subsequently had spontaneous preterm delivery and to assess the clinical utility of the measurement in the prediction of preterm delivery. DESIGN: A prospective observational study. SETTING: Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong. POPULATION: 1047 low risk pregnant women recruited at 15-20 weeks of gestation. METHODS: Venous samples were assayed for levels of corticotrophin-releasing hormone. The investigators responsible for the laboratory assay were blinded to the obstetric outcome. MAIN OUTCOME MEASURES: Incidence of preterm, term and post-term pregnancies. RESULTS: Those who were delivered spontaneously at a preterm gestational age (before 34 weeks) had significantly higher corticotrophin-releasing hormone levels in the mid-trimester, compared with those who were delivered at term or post-term. There was a trend towards lower corticotrophin-releasing hormone levels with more advanced gestational age at delivery. When the measurement of corticotrophin- releasing hormone was used to predict delivery before 34 weeks, the best cut off was 1.9 MoM, which produced a sensitivity of 72.7% and specificity of 78.4%. This translated to a positive predictive value of 3.6%, negative predictive value of 99.6% and relative risk of 9.4 when the background prevalence of spontaneous preterm delivery before 34 weeks was 1.1%. The likelihood ratio was 3.4. CONCLUSIONS: Mid-trimester maternal corticotrophin-releasing hormone levels are elevated in pregnancies destined to deliver preterm before 34 weeks. When used alone in a low risk population, the measurement has a low predictive power for preterm delivery. However, the likelihood ratio of 3 4 implies that in high risk populations the test may be considerably more valuable.
T N Leung; T K Chung; G Madsen; M McLean; A M Chang; R Smith
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  106     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-29     Completed Date:  1999-10-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1041-6     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin.
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MeSH Terms
Biological Markers / blood
Corticotropin-Releasing Hormone / blood*
Gestational Age
Obstetric Labor, Premature / blood*
Predictive Value of Tests
Pregnancy Trimester, Second / blood
Prospective Studies
Sensitivity and Specificity
Reg. No./Substance:
0/Biological Markers; 9015-71-8/Corticotropin-Releasing Hormone

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