Intercellular adhesion molecule-1 (ICAM-1) in cervicovaginal fluid of women presenting with preterm labor: Predictive value for preterm delivery

PROBLEM: Clinically useful tests for the prediction and diagnosis of preter m labor and delivery remain to be established. We have hypothesized that so luble intercellular adhesion molecule-1 (sICAM-1) in the cervicovaginal flu id of women with preterm labor may be a useful diagnostic tool. METHOD OF STUDY: The cervicovaginal fluid of 103 women between 24 degrees a nd 33(6) weeks gestation with preterm contractions and intact membranes was assayed for sICAM-1. RESULTS: Elevated sICAM-1 concentrations predicted short intervals to deliv ery (area under receiver-operator characteristic (ROC) curves, 0.70-0.72 fo r delivery within 3, 7 and 10 days), with high specificity. Characteristics for delivery within 3 days at a 3 ng/mL threshold for a positive test were sensitivity 33.3%, specificity 98.9% and positive and negative predictive values of 75.0% and 93.9%, respectively. Predictive ability was independent of and complementary to that of fetal fibronectin (fFN). CONCLUSIONS: Measurement of sICAM-1 in cervicovaginal fluid has potential a s a predictor of preterm delivery in women with symptoms of preterm labor, particularly in conjunction with fFN testing.