Evaluation of Serum Level of Thrombin-antithrombin III in Preterm Labors

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Obstetrics and Gynecology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Preterm labors still have a high rate of morbidity and mortality. This study was designed to evaluate the serum level of Thrombin-Antithrombin III (TAT-III) as a test in predicting preterm labor.Methods: This cross-sectional study was conducted from 2009 to 2010 at the two university hospitals of Shaheed Beheshty, and Al-Zahra, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. 128 pregnant women with a gestational age between 14 to 16 weeks were enrolled in the study and followed until delivery. The mean of TAT-III was compared between preterm labors and term labors. The optimal cut off and sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were determined.Findings: The mean of maternal age was 24.7 ± 5.04 years (15-37 years), and the mean of gestational age was 31.5 ± 3.21 weeks (25-36 weeks). The mean of TAT-III serum level was significantly different between preterm labors and term labors (9.7 ± 3.6 vs. 7.3 ± 0.87 ng/mL, P = 0.000). The optimal cut off point was 8.3850 ng/mL, sensitivity was 70.3%, specificity 81.2%, PPV 78.9%, and NPV 73.2%. Conclusion: This study indicated that lamellar body counting test has a high PPV with good sensitivity, specificity, and NPV. Future studies with control in biases are warranted.

Keywords


  1. Ramsey PS, Andrews WW. Biochemical predic-tors of preterm labor: fetal fibronectin and sali-vary estriol. Clin Perinatol 2003; 30(4): 701-33.
  2. Thorsen P, Schendel DE, Deshpande AD, Vogel I, Dudley DJ, Olsen J. Identification of biologi-cal/biochemical marker(s) for preterm delivery. Paediatr Perinat Epidemiol 2001; 15 Suppl 2: 90-103.
  3. Menon R, McIntyre JO, Matrisian LM, Fortu-nato SJ. Salivary proteinase activity: a potential biomarker for preterm premature rupture of the membranes. Am J Obstet Gynecol 2006; 194(6): 1609-15.
  4. Yeast JD, Lu G. Biochemical markers for the prediction of preterm labor. Obstet Gynecol Clin North Am 2005; 32(3): 369-81.
  5. Goldenberg RL, Goepfert AR, Ramsey PS. Bio-chemical markers for the prediction of preterm birth. Am J Obstet Gynecol 2005; 192(5 Suppl): S36-S46.
  6. Lockwood CJ, Kuczynski E. Markers of risk for preterm delivery. J Perinat Med 1999; 27(1):
  7. -20.
  8. Leszczynska-Gorzelak B, Poniedzialek-Czajkowska E. Biochemical markers of preterm elivery. Med Wieku Rozwoj 2003; 7(3 Suppl 1): 51-64.
  9. Elovitz MA, Baron J, Phillippe M. The role of thrombin in preterm parturition. Am J Obstet Gynecol 2001; 185(5): 1059-63.
  10. Chaiworapongsa T, Espinoza J, Yoshimatsu J, Kim YM, Bujold E, Edwin S, et al. Activation of coagulation system in preterm labor and preterm premature rupture of membranes. J Matern Fetal Neonatal Med 2002; 11(6): 368-73.
  11. Catov JM, Bodnar LM, Hackney D, Roberts JM, Simhan HN. Activation of the fibrinolytic cas-cade early in pregnancy among women with spontaneous preterm birth. Obstet Gynecol 2008; 112(5): 1116-22.
  12. Smith GD, Sterne J, Tynelius P, Lawlor DA, Rasmussen F. Birth weight of offspring and sub-sequent cardiovascular mortality of the parents. Epidemiology 2005; 16(4): 563-9.
  13. Rosen T, Kuczynski E, O'Neill LM, Funai EF, Lockwood CJ. Plasma levels of thrombin-antithrombin complexes predict preterm prema-ture rupture of the fetal membranes. Matern Fe-tal Med. 2001 Oct; 10(5): 297-300.
  14. Erez O, Romer R, Vaisbuch E, Chaiworapongsa T, Kusanovic JP, Mazaki-Tovi S, et al. Changes in amniotic fluid concentration of thrombin-antithrombin III complexes in patients with pre-term labor: evidence of an increased thrombin generation. J Matern Fetal Neonatal Med. 2009; 22(11): 971-82.