Prediction of Preterm Delivery Using Serum Ischemia Modified Albumin, Biglycan, and Decorin Levels in Women with Threatened Preterm Labor

Biyik, Ismail; Soysal, Cenk; Ince, Ozlem Ulas Onur; Durmus, Sinem; Oztas, Efser; Keskin, Nadi; Isiklar, Ozben Ozden; Karaagac, Oğuz Han; Gelisgen, Remise; Uzun, Hafize

doi:10.1055/s-0043-1772593

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Revista Brasileira de Ginecologia e Obstetrícia

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Original Article, High Risk Pregnancy • Rev Bras Ginecol Obstet 45 (12) • 2023 • https://doi.org/10.1055/s-0043-1772593 copy

Prediction of Preterm Delivery Using Serum Ischemia Modified Albumin, Biglycan, and Decorin Levels in Women with Threatened Preterm Labor

Previsão de parto prematuro usando albumina modificada por isquemia sérica, biglicano e níveis de decorina em mulheres com ameaça de trabalho de parto prematuro

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

The serum ischemia modified albumin (IMA), biglycan, and decorin levels of pregnant women who were hospitalized for threatened preterm labor were measured.

Methods

Fifty-one consecutive pregnant women with a single pregnancy between the 24^th and 36^th weeks with a diagnosis of threatened preterm labor were included in the present prospective cohort study.

Results

As a result of multivariate logistic regression analysis for predicting preterm delivery within 24 hours, 48 hours, 7 days, 14 days, ≤ 35 gestational weeks, and ≤ 37 gestational weeks after admission, area under the curve (AUC) (95% confidence interval [CI[) values were 0.95 (0.89–1.00), 0.93 (0.86–0.99), 0.91 (0.83–0.98), 0.92 (0.85–0.99), 0.82 (0.69–0.96), and 0.89 (0.80–0.98), respectively. In the present study, IMA and biglycan levels were found to be higher and decorin levels lower in women admitted to the hospital with threatened preterm labor and who gave preterm birth within 48 hours compared with those who gave birth after 48 hours.

Conclusion

In pregnant women admitted to the hospital with threatened preterm labor, the prediction preterm delivery of the combined model created by adding IMA, decorin, and biglycan in addition to the TVS CL measurement was higher than the TVS CL measurement alone.

Clinical trial registration

The present trial was registered at ClinicalTrials.gov, number NCT04451928.

Keywords
ischemia modified albumin; biglycan decorin; preterm delivery prediction; threatened preterm labor; preterm delivery

		24 hours			48 hours			7 days
Preterm birth ratio		25.5% (13/51)			29.4% (15/51)			37.3% (19/51)
		OR (95%CI)	p-value	AUC (95%CI)	OR (%95CI)	p-value	AUC (95%CI)	OR (%95CI)	p-value	AUC (95%CI)
IMA		1.07 (1.02–1.15)	0.014 ^* * Statistically significant comparisons were marked with.	0.69 (0.51–0.872)	1.07 (1.02–1.14)	0.014 ^* * Statistically significant comparisons were marked with.	0.68 (0.50–0.86)	1.07 (1.02–1.15)	0.013 ^* * Statistically significant comparisons were marked with.	0.68 (0.52–0.84)
Decorin		0.88 (0.75–1.00)	0.080	0.67 (0.51–0.83)	0.85 (0.72–0.97)	0.032 ^* * Statistically significant comparisons were marked with.	0.72 (0.57–0.8679)	0.85 (0.73–0.95)	0.014 ^* * Statistically significant comparisons were marked with.	0.73 (0.59–0.87)
Biglycan		1.01 (1.00–1.02)	0.019 ^* * Statistically significant comparisons were marked with.	0.74 (0.56–0.91)	1.01 (1.00–1.02)	0.024 ^* * Statistically significant comparisons were marked with.	0.70 (0.52–0.87)	1.01 (1.00–1.02)	0.019 ^* * Statistically significant comparisons were marked with.	0.71 (0.56–0.87)
Cervical Length		0.80 (0.67–0.90)	0.002 ^* * Statistically significant comparisons were marked with.	0.89 (0.80–0.98)	0.82 (0.70–0.92)	0.003 ^* * Statistically significant comparisons were marked with.	0.85 (0.75–0.96)	0.85 (0.74–0.94)	0.007 ^* * Statistically significant comparisons were marked with.	0.80 (0.67–0.93)
Combined model 1
	IMA	1.11 (1.01–1.25)	0.048 ^* * Statistically significant comparisons were marked with.	0.88 (0.78–0.98)	1.09 (1.01–1.21)	0.059	0.86 (0.76–0.96)	1.10 (1.01–1.22)	0.043 ^* * Statistically significant comparisons were marked with.	0.88 (0.78–0.97)
	Decorin	0.84 (0.63–1.03)	0.157		0.81 (0.61–0.98)	0.069		0.82 (0.65–0.97)	0.043 ^* * Statistically significant comparisons were marked with.
	Biglycan	1.02 (1.01–1.04)	0.028 ^* * Statistically significant comparisons were marked with.		1.01 (1.00–1.03)	0.033 ^* * Statistically significant comparisons were marked with.		1.02 (1.01–1.03)	0.015 ^* * Statistically significant comparisons were marked with.
Combined model 2
	IMA	1.17 (1.03–1.42)	0.039 ^* * Statistically significant comparisons were marked with.	0.95 (0.89– 1)	1.13 (1.02–1.29)	0.040 ^* * Statistically significant comparisons were marked with.	0.93 (0.86–0.99)	1.12 (1.02–1.25)	0.031 ^* * Statistically significant comparisons were marked with.	0.91 (0.83–0.98)
	Decorin	0.71 (0.47–0.93)	0.042 ^* * Statistically significant comparisons were marked with.		0.74 (0.55–0.93)	0.022 ^* * Statistically significant comparisons were marked with.		0.79 (0.61–0.95)	0.025 ^* * Statistically significant comparisons were marked with.
	Biglycan	1.02 (1.00–1.04)	0.100		1.01 (1.00–1.03)	0.161		1.01 (1.00–1.03)	0.061
Cervical Length		0.65 (0.41–0.86)	0.018 ^* * Statistically significant comparisons were marked with.		0.74 (0.55–0.91)	0.016 ^* * Statistically significant comparisons were marked with.		0.83 (0.67–0.98)	0.044 ^* * Statistically significant comparisons were marked with.

		14 days			< 35 weeks			< 37 weeks
Preterm birth ratio		45.1% (23/51)			23.5% (12/51)			51.0% (26/51)
		OR (95%CI)	p-value	AUC (95%CI)	OR (95%CI)	p-value	AUC (95%CI)	OR (95%CI)	p-value	AUC (95%CI)
IMA		1.07 (1.02–1.15)	0.013 ^* * Statistically significant comparisons were marked with.	0.67 (0.52–0.82)	1.01 (0.96–1.05)	0.827	0.51 (0.31–0.71)	1.04 (1.00–1.10)	0.085	0.60 (0.44–0.76)
Decorin		0.85 (0.73–0.95)	0.014 ^* * Statistically significant comparisons were marked with.	0.72 (0.57– 0.86)	0.93 (0.81–1.04)	0.245	0.61 (0.43–0.79)	0.87 (0.77–0.96)	0.012 ^* * Statistically significant comparisons were marked with.	0.71 (0.56–0.86)
Biglycan		1.01 (1.00–1.02)	0.019 ^* * Statistically significant comparisons were marked with.	0.73 (0.59–0.88)	1.00 (1.00–1.01)	0.271	0.70 (0.54–0.86)	1.01 (1.00–1.02)	0.017 ^* * Statistically significant comparisons were marked with.	0.71 (0.57–0.85)
Cervical Length		0.85 (0.74–0.94)	0.007	0.83 (0.72–0.95)	0.88 (0.78–0.97)	0.014 ^* * Statistically significant comparisons were marked with.	0.82 (0.70–0.93)	0.77 (0.63–0.89)	0.002 ^* * Statistically significant comparisons were marked with.	0.81 (0.68–0.93)
Combined model 1
	IMA	1.08 (1.01–1.18)	0.060	0.86 (0.76–0.96)	0.98 (0.92–1.04)	0.503	0.69 (0.50–0.88)	1.03 (0.97–1.10)	0.386	0.82 (0.70–0.94)
	Decorin	0.85 (0.71–0.99)	0.051		0.92 (0.80–1.04)	0.215		0.88 (0.76–0.99)	0.046 ^* * Statistically significant comparisons were marked with.
	Biglycan	1.02 (1.01–1.03)	0.008 ^* * Statistically significant comparisons were marked with.		1.00 (1.00–1.01)	0.213		1.01 (1.00–1.02)	0.020 ^* * Statistically significant comparisons were marked with.
Combined model 2
	IMA	1.12 (1.02–1.25)	0.031 ^* * Statistically significant comparisons were marked with.	0.92 (0.85–0.99)	0.99 (0.93–1.05)	0.719	0.82 (0.69–0.96)	1.04 (0.96–1.14)	0.319	0.89 (0.80–0.98)
	Decorin	0.79 (0.61–0.95)	0.025 ^* * Statistically significant comparisons were marked with.		0.91 (0.78–1.04)	0.193		0.85 (0.71–0.99)	0.047 ^* * Statistically significant comparisons were marked with.
	Biglycan	1.01 (1.00–1.03)	0.061		1.00 (0.99–1.00)	0.966		1.01 (1.00–1.02)	0.192
Cervical Length		0.83 (0.67–0.98)	0.044 ^* * Statistically significant comparisons were marked with.		0.87 (0.76–0.97)	0.020 ^* * Statistically significant comparisons were marked with.		0.81 (0.67–0.94)	0.012 ^* * Statistically significant comparisons were marked with.

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[1] Address for correspondence Ismail Biyik, Associate Professor Kütahya Sağlık Bilimleri Üniversitesi Alipaşa Mahallesi Fatih Sultan Mehmet Bulvarı No:22 Merkez/Kütahya Turkey dribiyik@hotmail.com

Age (years old)	29.13 ± 6.65
Age (years old)	29.00 [23.0–34.0]
BMI (kg/m2)	22.72 ± 3.66
BMI (kg/m2)	22.6 [20.3–25.0]
Gravidity	2.27 ± 1,11
Gravidity	2 [1–3]
Parity	1.01 ± 0.88
Parity	1 [0–2]
Gestational age (weeks)	34.23 ± 2.71
Gestational age (weeks)	34.86 [33.43–36.29]
IMA (ng/mL)	43.17 ± 14.08
IMA (ng/mL)	50.53 [34.34–49.07]
Decorin (ng/mL)	14.87 ± 6.27
Decorin (ng/mL)	12.65 [9.53–18.73]
Biglycan (pg/mL)	465.07 ± 175.68
Biglycan (pg/mL)	435.0 [382.0–477.0]
Cervical length (mm)	30.81 ± 6.84
Cervical length (mm)	32.0 [28.0–35.2]
Gestational age at delivery (weeks)	36.94 ± 2.70
Gestational age at delivery (weeks)	37.14 [36.29–39.0]
Newborn weight (g)	2951.09 ± 552.30
Newborn weight (g)	3130.0 [2710.0–3280.0]
Steroid/tocolytic administration	50.98% (26/51)
Neonatal intensive care need	39.2% (20/51)