Maternal serum dehydroepiandrosterone sulfate as a predictor of labor inhibition in preterm labor

Abstract

Objective The aim of this study was to assess the relationship between endogenous serum dehydroepiandrosterone sulfate (DHEA-S) levels and success of labor inhibition in preterm labor. Background Preterm birth is the leading cause of neonatal mortality and morbidity. Patients and methods This prospective trial included 43 pregnant women with preterm labor. Labor inhibition was achieved using calcium channel blockers such as nifedipine (epilat 10-mg capsules at a dose of 10 mg orally every 20 min until uterine contractions are inhibited and maintained regularly by epilat retard tablets every 8 h). Serum DHEA-S levels were measured twice, the first just before labor inhibition by tocolytic drugs, and the second sample was obtained after 48 h from starting tocolytic drugs. The levels were evaluated by radioimmunoassay. Ultrasound assessment of the cervix was also carried out. Results There was a highly significant statistical difference between cases delivered at full term (n = 29) and cases delivered preterm (n = 14) regarding post-tocolytic DHEA-S levels (P = 0.0009). There was a significant statistical difference in pretocolytic levels of DHEA-S in cases that delivered preterm and failed to respond to tocolytic therapy. The cutoff value of pretocolytic DHEA-S was greater than or equal to 94 μg/dl, at which tocolytic therapy failed. Conclusion Maternal serum DHEA-S concentrations were normal in patients with successful tocolysis compared with elevated levels in patients with failed tocolysis who experienced preterm delivery. Elevated serum DHEA-S levels of more than 94 μg/dl could be used to predict failure of labor inhibition in preterm labor.