Startseite 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
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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

  • Sven Kehl EMAIL logo , Christel Weiss , Jutta Pretscher , Friederike Baier , Florian Faschingbauer , Matthias W. Beckmann und Florian M. Stumpfe ORCID logo
Veröffentlicht/Copyright: 19. Juli 2021
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 49 Heft 9

Abstract

Objectives

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.

Methods

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).

Results

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).

Conclusions

Addition of biomarker testing can help to avoid unnecessary ACS administrations in women with shortened cervical length.

Keywords: antenatal corticosteroids; foetal fibronectin; iatrogenic; placental alpha-microglobulin-1 (PAMG-1); preterm delivery; short cervix; shortened cervical length
Corresponding author: Prof. Dr. med. habil. Sven Kehl, Department of Obstetrics and Gynecology, Erlangen University Hospital, Universitätsstr. 21/23 91054 Erlangen, Germany, Phone: +49 9131 85 33553, Fax: +49 9131 85 33553, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Sven Kehl received speaker fee from Qiagen. The other authors declare that they have no financial, personal, political, intellectual or religious interests.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: All procedures were in accordance with the ethical standards of the Institutional Research Committee, national Research Committee, and the 1964 Helsinki Declaration and its later amendments. The local Ethics Committee approved the study (09.12.2016/VK).

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Received: 2021-01-29
Accepted: 2021-06-01
Published Online: 2021-07-19
Published in Print: 2021-11-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
  4. Commentary
  5. Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
  6. WAPM Recommendations
  7. WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
  8. Corner of Academy
  9. Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
  10. Original Articles – Obstetrics
  11. The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
  12. Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
  13. Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
  14. Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
  15. Risk of metformin failure in the treatment of women with gestational diabetes
  16. Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
  17. New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
  18. Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
  19. Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
  20. Maternal and neonatal outcomes in women with disorders of lipid metabolism
  21. 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
  22. Original Articles – Neonates
  23. The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
  24. Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
  25. Impact of paternal presence and parental social-demographic characteristics on birth outcomes
  26. Letter to the Editor
  27. Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
https://doi.org/10.1515/jpm-2021-0048
Schlagwörter für diesen Artikel
antenatal corticosteroids; foetal fibronectin; iatrogenic; placental alpha-microglobulin-1 (PAMG-1); preterm delivery; short cervix; shortened cervical length

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
  4. Commentary
  5. Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
  6. WAPM Recommendations
  7. WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
  8. Corner of Academy
  9. Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
  10. Original Articles – Obstetrics
  11. The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
  12. Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
  13. Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
  14. Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
  15. Risk of metformin failure in the treatment of women with gestational diabetes
  16. Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
  17. New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
  18. Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
  19. Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
  20. Maternal and neonatal outcomes in women with disorders of lipid metabolism
  21. 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
  22. Original Articles – Neonates
  23. The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
  24. Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
  25. Impact of paternal presence and parental social-demographic characteristics on birth outcomes
  26. Letter to the Editor
  27. Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
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