The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration.
Adult
Cervical Length Measurement
/ methods
Cohort Studies
Female
Germany
/ epidemiology
Glucocorticoids
/ administration & dosage
Humans
Insulin-Like Growth Factor Binding Protein 1
/ analysis
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
/ epidemiology
Premature Birth
/ diagnosis
Prenatal Care
/ methods
Risk Assessment
Time-to-Treatment
Ultrasonography, Prenatal
/ methods
Unnecessary Procedures
Uterine Cervical Incompetence
/ diagnosis
antenatal corticosteroids
foetal fibronectin
iatrogenic
placental alpha-microglobulin-1 (PAMG-1)
preterm delivery
short cervix
shortened cervical length
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
25 Nov 2021
25 Nov 2021
Historique:
received:
29
01
2021
accepted:
01
06
2021
pubmed:
17
7
2021
medline:
11
2
2022
entrez:
16
7
2021
Statut:
epublish
Résumé
To assess the frequency of antenatal corticosteroid (ACS) administration in cases with shortened cervical length by addition of placental alpha-microglobulin-1 (PAMG-1) testing to sonographic examination. Single centre retrospective cohort study. Rate of ACS administration was compared between cases with cervical length between 15 and 25 mm and cases with positive PAMG-1 testing and cervical length between 15 and 25 mm. We evaluated the following outcome parameters: Rate of ACS administration, gestational age at delivery, time to delivery, delivery within seven days, delivery <34 and <37 weeks' gestation, rate of admission to neonatal intensive care unit (NICU). In total, 130 cases were included. "PAMG-1 group" consisted of 68 women, 62 cases built the "historical control group". ACS administration was performed less frequently in the "PAMG-1 cohort" (18 (26%) vs. 46 (74%); p<0.001). The rate of delivery within seven days did not differ (2 (3%) vs. 4 (6.5%); p=0.4239). The rates of delivery <34 weeks' gestation (7 (10%) vs. 9 (15%); p=0.4643) and <37 weeks' gestation (19 (28%) vs. 26 (42%); p=0.0939) did not differ. Time to delivery interval was longer in the PAMG-1 group (61.5 vs. 43 days, p=0.0117). NICU admission occurred more often in the "historical control group" (22 (38%) vs. 28 (60%); p=0.0272). Addition of biomarker testing can help to avoid unnecessary ACS administrations in women with shortened cervical length.
Identifiants
pubmed: 34271603
pii: jpm-2021-0048
doi: 10.1515/jpm-2021-0048
doi:
Substances chimiques
Glucocorticoids
0
IGFBP1 protein, human
0
Insulin-Like Growth Factor Binding Protein 1
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1135-1140Informations de copyright
© 2021 Walter de Gruyter GmbH, Berlin/Boston.
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