HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by HOLZMAN, C. Articles by RIP, T. Search for Related Content PubMed PubMed Citation Articles by HOLZMAN, C. Articles by RIP, T.

Second Trimester Corticotropin-Releasing Hormone Levels in Relation to Preterm Delivery and Ethnicity

From the Departments of Epidemiology, and Pediatrics and Human Development, Michigan State University, East Lansing, Michigan; and the Department of Obstetrics and Gynecology, University of Texas, San Antonio, Texas.

Address reprint requests to: Claudia Holzman, DVM, PhD Department of Epidemiology Michigan State University 4660 South Hagadorn, Suite 600 East Lansing, MI 48823 E-mail: holzman{at}msu.edu

Objective: To assess the relationship between maternal corticotropin-releasing hormone (CRH) levels in second trimester sera, and the risk of preterm delivery in an ethnically heterogeneous sample of pregnant women.

Methods: This nested case-control study included two case groups (97 women who delivered before 35 weeks’ gestation, 144 who delivered at 35–36 weeks’ gestation), and a control group (244 women who delivered at or after 37 weeks’ gestation) frequency matched by ethnicity (black, white) and by alpha-fetoprotein levels (normal, unexplained high). Corticotropin-releasing hormone was evaluated in stored maternal sera collected at 15–19 weeks’ gestation from cases and controls.

Results: Delivery before 35 weeks’ gestation was associated positively with a second trimester, ethnic-specific CRH above 1.5 multiples of the median in white women [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.1, 5.1] and black women (OR 5.0, 95% CI 1.8, 13.3). Sensitivity was 29% in whites and 41% in blacks; specificity was 84% in whites and 80% in blacks. We estimated the positive and negative predictive values to be 6% and 97%, respectively, in white women, and 16% and 93%, respectively, in black women. It was also noted that, within case and control groups, black women had consistently lower CRH levels than white women.

Conclusion: Factors that lead to a premature increase in placental CRH production and are associated with an increased risk of preterm birth are evident as early as 15–19 weeks’ pregnancy. When considering potential links between stressors, placental changes, CRH levels, and preterm birth, it might be important to stratify or adjust for ethnicity.

This article has been cited by other articles:

				R. Menon, C. P. Arora, C. J. Hobel, and S. J. Fortunato Corticotrophin-Releasing Hormone in Lipopolysaccharide-Stimulated Term Fetal Membranes and Amniotic Fluid From Term and Preterm Birth in African Americans and Caucasians Reproductive Sciences, May 1, 2008; 15(5): 477 - 483. [Abstract] [PDF]

				J. Dayan, C. Creveuil, M. N. Marks, S. Conroy, M. Herlicoviez, M. Dreyfus, and S. Tordjman Prenatal Depression, Prenatal Anxiety, and Spontaneous Preterm Birth: A Prospective Cohort Study Among Women With Early and Regular Care Psychosom Med, November 1, 2006; 68(6): 938 - 946. [Abstract] [Full Text] [PDF]

				T. M. Siler-Khodr, G. Forthman, C. Khodr, S. Matyszczyk, Z. Khodr, and G. Khodr Maternal Serum Corticotropin-Releasing Hormone at Midgestation in Hispanic and White Women Obstet. Gynecol., March 1, 2003; 101(3): 557 - 564. [Abstract] [Full Text] [PDF]