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Inflammatory biomarkers and spontaneous preterm birth among obese women
Authors:Matthew B. Wallenstein  Laura L. Jelliffe-Pawlowski  Wei Yang  Suzan L. Carmichael  David K. Stevenson  Kelli K. Ryckman
Affiliation:1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA,;2. Department of Epidemiology &3. Biostatistics, UCSF Preterm Birth Initiative, University of California San Francisco School of Medicine, San Francisco, CA, USA, and;4. Department of Epidemiology, University of Iowa, Iowa City, IA, USA
Abstract:Objective: To identify associations between second-trimester serum inflammatory biomarkers and preterm birth among obese women.

Methods: In this nested case-control study, we compared 65 serum inflammatory biomarkers in obese women whose pregnancies resulted in early spontaneous preterm birth (<32 weeks gestation, n?=?34) to obese women whose pregnancies resulted in term birth (n?=?34). These women were selected from a larger population-based California cohort. Random forest and classification and regression tree techniques were employed to identify biomarkers of importance, and adjusted odds ratios (aORs) and 95% confidence intervals (CI) were estimated using logistic regression.

Results: Random forest and classification and regression tree techniques found that soluble vascular endothelial growth factor receptor-3 (sVEGFR3), soluble interleukin-2 receptor alpha-chain (sIL-2RA) and soluble tumor necrosis factor receptor-1 (sTNFR1) were related to preterm birth. Using multivariable logistic regression to compare preterm cases and term controls, decreased serum levels of sVEGFR3 and increased serum levels of sIL-2RA and sTNFR1 were associated with increased risk of preterm birth among obese women, aOR?=?3.2 (95% CI: 1.0–9.9), aOR?=?2.8 (95% CI: 0.9–9.0), and aOR?=?4.1 (95% CI: 1.2–14.1), respectively.

Conclusions: In this pilot study, we identified three serum biomarkers indicative of inflammation to be associated with spontaneous preterm birth among obese women: sVEGFR3, sIL-2RA and sTNFR1.
Keywords:Inflammation  inflammatory markers  obesity  preterm birth  soluble interleukin-2 receptor alpha-chain  soluble tumor necrosis factor receptor-1  vascular endothelial growth factor  vascular endothelial growth factor receptor-3
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