Clinical application of amino-terminal pro-brain natriuretic peptide concentration in amniotic fluid for the prediction of preterm birth in symptomatic women

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dc.article.number100345
dc.catalogadorpva
dc.contributor.authorFerrer Márquez, Fernando Andrés
dc.contributor.authorAstudillo Goic, Rocío Pilar
dc.contributor.authorCarvajal C., Jorge A.
dc.date.accessioned2024-04-23T20:21:53Z
dc.date.available2024-04-23T20:21:53Z
dc.date.issued2024
dc.description.abstractBACKGROUND: Preterm birth accounts for 60% to 80% of neonatal mortality. Approximately one-third of preterm births are caused by the spontaneous onset of preterm labor. Nevertheless, 70% to 90% of women diagnosed with preterm labor will not deliver within 7 days. Thus, many women will be unnecessarily treated by preterm labor with risk medications. Better tools are needed to categorize women in preterm labor into high or low risk of preterm delivery.OBJECTIVE: This study aimed to evaluate the amino-terminal pro-brain natriuretic peptide concentration in the amniotic fluid as a prognostic test to predict the risk of delivery within 48 hours or 7 days and before 34 0/7 or 37 0/7 weeks of gestation in women in preterm labor.STUDY DESIGN: A total of 102 pregnant women presenting signs and symptoms of spontaneous preterm birth (22 0/7 to 34 0/7 weeks of gestation) were included. Amniotic fluid was obtained by amniocentesis, and amino-terminal pro-brain natriuretic peptide concentration was measured. Below normal concentration was defined as <0.5 multiples of the median of the standard curve according to gestational age. The risk of preterm delivery was estimated according to normal or lower-than-normal amino-terminal pro-brain natriuretic peptide concentrations. The predictive capacity of the test (below normal amino-terminal pro-brain natriuretic peptide concentration) was evaluated to identify spontaneous preterm birth at 48 hours or 7 days from amniocentesis and less than 34 0/7 or 37 0/7 weeks at delivery.RESULTS: For the outcome delivery within 48 hours, lower-than-normal amino-terminal pro-brain natriuretic peptide concentration had 94.6% sensitivity, 73.8% specificity, 96.0% negative predictive value, 3.61 positive likelihood ratio, and 0.07 negative likelihood ratio. For the outcome delivery within 7 days, the test had 93.9% sensitivity, 88.7% specificity, 94.0% negative predictive value, 8.31 positive likelihood ratio, and 0.07 negative likelihood ratio. For the outcomes of spontaneous preterm birth before 34 0/7 and 37 0/7 weeks of gestation, below normal amino-terminal pro-brain natriuretic peptide concentrations had 80.0% sensitivity, 83.0% specificity, 78.0% negative predictive value, 4.70 positive likelihood ratio, and 0.24 negative likelihood ratio and 64.1% sensitivity, 91.7% specificity, 44.0% negative predictive value, 7.70 positive likelihood ratio, and 0.39 negative likelihood ratio, respectively.CONCLUSION: Among patients in spontaneous preterm labor, the detection of lower-than-normal amino-terminal pro-brain natriuretic peptide concentrations (<0.5 multiples of the median) in amniotic fluid has an excellent predictive capacity to identify those patients at low risk of preterm delivery within 48 hours or 7 days.
dc.fechaingreso.objetodigital2024-04-23
dc.fuente.origenORCID
dc.identifier.doi10.1016/j.xagr.2024.100345
dc.identifier.urihttps://doi.org/10.1016/j.xagr.2024.100345
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/85306
dc.information.autorucEscuela de Medicina; Ferrer Márquez, Fernando Andrés; 0000-0002-0738-8621; 227733
dc.information.autorucEscuela de Medicina; Astudillo Goic, Rocío Pilar; S/I; 234429
dc.information.autorucEscuela de Medicina; Carvajal C., Jorge A.; 0000-0001-6875-7825; 3345
dc.issue.numero2
dc.language.isoen
dc.nota.accesocontenido completo
dc.pagina.final6
dc.pagina.inicio1
dc.revistaAJOG Global Reports
dc.rightsacceso abierto
dc.rights.licenseAttribution-NonCommercial-NoDerivs 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAmino-terminal pro-brain natriuretic peptide
dc.subjectAmniotic fluid
dc.subjectPreterm delivery
dc.subjectPreterm labor
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleClinical application of amino-terminal pro-brain natriuretic peptide concentration in amniotic fluid for the prediction of preterm birth in symptomatic women
dc.typeartículo
dc.volumen4
sipa.codpersvinculados227733
sipa.codpersvinculados234429
sipa.codpersvinculados3345
sipa.trazabilidadORCID;2024-04-22
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