Performance of a proteomic preterm delivery predictor in a large independent prospective cohort

Simple item page
dc.contributor.authorMarkenson, Glenn R.
dc.contributor.authorSaade, George R.
dc.contributor.authorLaurent, Louise C.
dc.contributor.authorHeyborne, Kent D.
dc.contributor.authorCoonrod, Dean V.
dc.contributor.authorSchoen, Corina N.
dc.contributor.authorBaxter, Jason K.
dc.contributor.authorHaas, David M.
dc.contributor.authorLongo, Sherri
dc.contributor.authorGrobman, William A.
dc.contributor.authorSullivan, Scott A.
dc.contributor.authorMajor, Carol A.
dc.contributor.authorWheeler, Sarahn M.
dc.contributor.authorPereira, Leonardo M.
dc.contributor.authorSu, Emily J.
dc.contributor.authorBoggess, Kim A.
dc.contributor.authorHawk, Angela F.
dc.contributor.authorCrockett, Amy H.
dc.contributor.authorFox, Angela C.
dc.contributor.authorPolpitiya, Ashoka
dc.contributor.authorFleischer, Tracey C.
dc.contributor.authorCritchfield, Gregory C.
dc.contributor.authorBurchard, Julja
dc.contributor.authorBoniface, J. Jay
dc.contributor.authorLam, Garrett K.
dc.contributor.departmentObstetrics and Gynecology, School of Medicineen_US
dc.date.accessioned2022-02-02T21:47:27Z
dc.date.available2022-02-02T21:47:27Z
dc.date.issued2020-08
dc.description.abstractBackground Preterm birth remains a common and devastating complication of pregnancy. There remains a need for effective and accurate screening methods for preterm birth. Using a proteomic approach, we previously discovered and validated (Proteomic Assessment of Preterm Risk study, NCT01371019) a preterm birth predictor comprising a ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin. Objective To determine the performance of the ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin to predict both spontaneous and medically indicated very preterm births, in an independent cohort distinct from the one in which it was developed. Study Design This was a prospective observational study (Multicenter Assessment of a Spontaneous Preterm Birth Risk Predictor, NCT02787213) at 18 sites in the United States. Women had blood drawn at 170/7 to 216/7 weeks’ gestation. For confirmation, we planned to analyze a randomly selected subgroup of women having blood drawn between 191/7 and 206/7 weeks’ gestation, with the results of the remaining study participants blinded for future validation studies. Serum from participants was analyzed by mass spectrometry. Neonatal morbidity and mortality were analyzed using a composite score by a method from the PREGNANT trial (NCT00615550, Hassan et al). Scores of 0–3 reflect increasing numbers of morbidities or length of neonatal intensive care unit stay, and 4 represents perinatal mortality. Results A total of 5011 women were enrolled, with 847 included in this planned substudy analysis. There were 9 preterm birth cases at <320/7 weeks’ gestation and 838 noncases at ≥320/7 weeks’ gestation; 21 of 847 infants had neonatal composite morbidity and mortality index scores of ≥3, and 4 of 21 had a score of 4. The ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin ratio was substantially higher in both preterm births at <320/7 weeks’ gestation and there were more severe neonatal outcomes. The ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin ratio was significantly predictive of birth at <320/7 weeks’ gestation (area under the receiver operating characteristic curve, 0.71; 95% confidence interval, 0.55–0.87; P=.016). Stratification by body mass index, optimized in the previous validation study (22<body mass index≤37 kg/m2), resulted in an area under the receiver operating characteristic curve of 0.76 (95% confidence interval, 0.59–0.93; P=.023). The ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin ratio predicted neonatal outcomes with respective area under the receiver operating characteristic curve of 0.67 (95% confidence interval, 0.57–0.77; P=.005) and 0.78 (95% confidence interval, 0.63–0.93; P=.026) for neonatal composite morbidity and mortality scores of ≥3 or 4. In addition, the ratio of insulin-like growth factor-binding protein 4 to sex hormone binding globulin significantly stratified neonates with increased length of hospital stay (log rank P=.023). Conclusion We confirmed in an independent cohort the ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin ratio as a predictor of very preterm birth, with additional prediction of increased length of neonatal hospital stay and increased severity of adverse neonatal outcomes. Potential uses of the ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin predictor may be to risk stratify patients for implementation of preterm birth preventive strategies and direct patients to appropriate levels of care.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationMarkenson, G. R., Saade, G. R., Laurent, L. C., Heyborne, K. D., Coonrod, D. V., Schoen, C. N., Baxter, J. K., Haas, D. M., Longo, S., Grobman, W. A., Sullivan, S. A., Major, C. A., Wheeler, S. M., Pereira, L. M., Su, E. J., Boggess, K. A., Hawk, A. F., Crockett, A. H., Fox, A. C., … Lam, G. K. (2020). Performance of a proteomic preterm delivery predictor in a large independent prospective cohort. American Journal of Obstetrics & Gynecology MFM, 2(3), 100140. https://doi.org/10.1016/j.ajogmf.2020.100140en_US
dc.identifier.urihttps://hdl.handle.net/1805/27670
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.ajogmf.2020.100140en_US
dc.relation.journalAmerican Journal of Obstetrics & Gynecology MFMen_US
dc.rightsPublisher Policyen_US
dc.sourcePublisheren_US
dc.subjectbiomarkeren_US
dc.subjectinsulin-like growth factor-binding protein 4en_US
dc.subjectneonatal morbidity and mortalityen_US
dc.titlePerformance of a proteomic preterm delivery predictor in a large independent prospective cohorten_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Markenson2020Performance.pdf
Size:
1.77 MB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.99 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Open Access Policy Articles
Department of Obstetrics and Gynecology Works