Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage

被引:34
|
作者
Lek, Sze Min [1 ]
Ku, Chee Wai [4 ]
Allen, John C., Jr. [1 ]
Malhotra, Rahul [1 ]
Tan, Nguan Soon [2 ,3 ]
Ostbye, Truls [1 ]
Tan, Thiam Chye [1 ,4 ]
机构
[1] Duke Natl Univ Singapore, Sch Med, 8 Coll Rd, Singapore 169857, Singapore
[2] Nanyang Technol Univ, Sch Biol Sci, 50 Nanyang Ave, Singapore 639798, Singapore
[3] ASTAR, Inst Mol & Cell Biol, 61 Biopolis Dr, Singapore 138673, Singapore
[4] KK Womens & Childrens Hosp, Dept Obstet & Gynecol, 100 Bukit Timah Rd, Singapore 229899, Singapore
关键词
Progesterone; Cut-off level; Predictive; Miscarriage; RISK-FACTORS; PREGNANCY; DIAGNOSIS;
D O I
10.1186/s12884-017-1261-4
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: Our recent paper, based on a pilot cohort of 119 women, showed that serum progesterone < 35 nmol/L was prognostic of spontaneous miscarriage by 16 weeks in women with threatened miscarriage in early pregnancy. Using a larger cohort of women from the same setting (validation cohort), we aim to assess the validity of serum progesterone < 35 nmol/L with the outcome of spontaneous miscarriage by 16 weeks. Methods: In a prospective cohort study, 360 pregnant women presenting with threatened miscarriage between gestation weeks 6-10 at a tertiary hospital emergency unit for women in Singapore were recruited for this study. The main outcome measure measured is spontaneous miscarriage prior to week 16 of gestation. Area under the ROC curve (AUC) and test characteristics (sensitivity, specificity, positive and negative predictive value) at a serum progesterone cutpoint of < 35 nmol/L for predicting high and low risk of spontaneous miscarriage by 16 weeks were compared between the Pilot and Validation cohorts. Results: Test characteristics and AUC values using serum progesterone < 35 nmol/L in the validation cohort were not significantly different from those in the Pilot cohort, demonstrating excellent accuracy and reproducibility of the proposed serum progesterone cut-off level. Conclusions: The cut-off value for serum progesterone (35 nmol/L) demonstrated clinical relevance and allow clinicians to stratify patients into high and low risk groups for spontaneous miscarriage.
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收藏
页数:7
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