THE ASSOCIATION BETWEEN SERUM FERRITIN AND PRETERM LABOR

Abstract

Preterm labor is usually defined as regular contractions accompanied by cervical changes occurring at less than 37 weeks' gestation. Preterm infants are at risk for specific diseases such as respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, sepsis, apnea and retinopathy. In about half the cases, the cause of preterm delivery is not known, but there is overwhelming evidence that infection is an important cause, probably accounting for up to 30% of cases. There is accumulating evidence to support this: Pro inflammatory cytokines such as interleukin 1, 6 & 8 and tumor necrosis factor alpha are found significantly increased concentrations in the amniotic fluid of women in spontaneous preterm labor with infection compared to women without infection. The presence of these cytokines in amniotic fluid and fetal blood has been shown to be associated with fetal and neonatal tissue damage; inflammation resulted in increased hepatic synthesis of ferritin. The increase in hepatic synthesis of ferritin is considered as an acute phase response to inflammation. The study population was 103 pregnant woman, they divided into two groups, the study group (n=53), and the control group (n=50). The results point out that there was significantly increase in serum ferritin level in the study group in comparative with control group. The serum ferritin level cut of point 90 was selected providing sensitivity equal to 98.1% and specificity of 86% in the diagnosis of preterm labor before completing 37 weeks.