SERUM FERRITIN - A PREDICTOR OF EARLY SPONTANEOUS PRETERM DELIVERY

Objective: To identify biochemical indices;for iron and protein nutrit ure as well as acute-phase reactants as predictors of preterm delivery . Methods: In this nested case-control study, serum samples were obtai ned at about 24 weeks' gestation from 94 indigent multiparas. These ca ses were defined based on having a spontaneous delivery of 32 weeks or less (n = 31) with two control groups, one delivering spontaneously a t 33-36 weeks (n = 32) and the other delivering spontaneously at 37 we eks or more (n = 31). The concentrations of iron, ferritin, transferri n, transferrin saturation, and transferrin receptor were measured as i ndices of iron status. The concentrations of acute-phase reactants, in cluding C-reactive protein, (alpha-2-macroglobulin, beta-2-microglobul in and ceruloplasmin, were also measured, along with albumin, prealbum in, retinol-binding protein, copper, and zinc. Results: Serum ferritin concentrations were negatively correlated with gestational age at bir th (P = .034). For subjects having serum ferritin levels above the med ian compared with those below, the odds ratio of having an early spont aneous preterm delivery was 2.99 (95% confidence interval 1.13-7.89). The other indices, including iron status and the acute-phase reactants , were not significantly associated with gestational age at birth. Con clusion: Elevated serum ferritin levels during the second trimester ar e predictive of early spontaneous preterm delivery, possibly because t hese reflect an acute-phase reaction to subclinical infections that ar e closely associated with premature delivery.