Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage

Background: Our recent paper, based on a pilot cohort of 119 women, showed that serum progesterone <35 nmol/L was prognostic of spontaneous miscarriage by 16 weeks in women with threatened miscarriage in early pregnancy. Using a larger cohort of women from the same setting (validation cohort), we...

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Main Authors: Lek, Sze Min, Ku, Chee Wai, Allen Jr, John C., Malhotra, Rahul, Tan, Nguan Soon, Østbye, Truls, Tan, Thiam Chye
Other Authors: School of Biological Sciences
Format: Article
Language:English
Published: 2018
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Online Access:https://hdl.handle.net/10356/88374
http://hdl.handle.net/10220/45744
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Institution: Nanyang Technological University
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spelling sg-ntu-dr.10356-883742023-02-28T17:02:25Z Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage Lek, Sze Min Ku, Chee Wai Allen Jr, John C. Malhotra, Rahul Tan, Nguan Soon Østbye, Truls Tan, Thiam Chye School of Biological Sciences Cut-off Level DRNTU::Science::Biological sciences Progesterone Background: Our recent paper, based on a pilot cohort of 119 women, showed that serum progesterone <35 nmol/L was prognostic of spontaneous miscarriage by 16 weeks in women with threatened miscarriage in early pregnancy. Using a larger cohort of women from the same setting (validation cohort), we aim to assess the validity of serum progesterone <35 nmol/L with the outcome of spontaneous miscarriage by 16 weeks. Methods: In a prospective cohort study, 360 pregnant women presenting with threatened miscarriage between gestation weeks 6–10 at a tertiary hospital emergency unit for women in Singapore were recruited for this study. The main outcome measure measured is spontaneous miscarriage prior to week 16 of gestation. Area under the ROC curve (AUC) and test characteristics (sensitivity, specificity, positive and negative predictive value) at a serum progesterone cutpoint of <35 nmol/L for predicting high and low risk of spontaneous miscarriage by 16 weeks were compared between the Pilot and Validation cohorts. Results: Test characteristics and AUC values using serum progesterone <35 nmol/L in the validation cohort were not significantly different from those in the Pilot cohort, demonstrating excellent accuracy and reproducibility of the proposed serum progesterone cut-off level. Conclusions: The cut-off value for serum progesterone (35 nmol/L) demonstrated clinical relevance and allow clinicians to stratify patients into high and low risk groups for spontaneous miscarriage. Published version 2018-08-29T08:19:50Z 2019-12-06T17:01:49Z 2018-08-29T08:19:50Z 2019-12-06T17:01:49Z 2017 Journal Article Lek, S. M., Ku, C. W., Allen Jr, J. C., Malhotra, R., Tan, N. S., Østbye, T., & Tan, T. C. (2017). Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage. BMC Pregnancy and Childbirth, 17(1), 78-. doi: 10.1186/s12884-017-1261-4 https://hdl.handle.net/10356/88374 http://hdl.handle.net/10220/45744 10.1186/s12884-017-1261-4 en BMC Pregnancy and Childbirth © 2017 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 7 p. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Cut-off Level
DRNTU::Science::Biological sciences
Progesterone
spellingShingle Cut-off Level
DRNTU::Science::Biological sciences
Progesterone
Lek, Sze Min
Ku, Chee Wai
Allen Jr, John C.
Malhotra, Rahul
Tan, Nguan Soon
Østbye, Truls
Tan, Thiam Chye
Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
description Background: Our recent paper, based on a pilot cohort of 119 women, showed that serum progesterone <35 nmol/L was prognostic of spontaneous miscarriage by 16 weeks in women with threatened miscarriage in early pregnancy. Using a larger cohort of women from the same setting (validation cohort), we aim to assess the validity of serum progesterone <35 nmol/L with the outcome of spontaneous miscarriage by 16 weeks. Methods: In a prospective cohort study, 360 pregnant women presenting with threatened miscarriage between gestation weeks 6–10 at a tertiary hospital emergency unit for women in Singapore were recruited for this study. The main outcome measure measured is spontaneous miscarriage prior to week 16 of gestation. Area under the ROC curve (AUC) and test characteristics (sensitivity, specificity, positive and negative predictive value) at a serum progesterone cutpoint of <35 nmol/L for predicting high and low risk of spontaneous miscarriage by 16 weeks were compared between the Pilot and Validation cohorts. Results: Test characteristics and AUC values using serum progesterone <35 nmol/L in the validation cohort were not significantly different from those in the Pilot cohort, demonstrating excellent accuracy and reproducibility of the proposed serum progesterone cut-off level. Conclusions: The cut-off value for serum progesterone (35 nmol/L) demonstrated clinical relevance and allow clinicians to stratify patients into high and low risk groups for spontaneous miscarriage.
author2 School of Biological Sciences
author_facet School of Biological Sciences
Lek, Sze Min
Ku, Chee Wai
Allen Jr, John C.
Malhotra, Rahul
Tan, Nguan Soon
Østbye, Truls
Tan, Thiam Chye
format Article
author Lek, Sze Min
Ku, Chee Wai
Allen Jr, John C.
Malhotra, Rahul
Tan, Nguan Soon
Østbye, Truls
Tan, Thiam Chye
author_sort Lek, Sze Min
title Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
title_short Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
title_full Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
title_fullStr Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
title_full_unstemmed Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
title_sort validation of serum progesterone <35nmol/l as a predictor of miscarriage among women with threatened miscarriage
publishDate 2018
url https://hdl.handle.net/10356/88374
http://hdl.handle.net/10220/45744
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