Prediction of preterm delivery using changes in serum relaxin in low risk pregnancies

Abstract

Objective To examine serum relaxin as a predictor of spontaneous preterm delivery. Study design A prospective study of 2846 women with singleton pregnancies, from which a matched case–control study (84 cases of spontaneous preterm delivery before 37 weeks gestation and 175 controls) and a cohort (84 preterm and 399 term deliveries) were extracted. Results In the women with a subsequent preterm delivery the relaxin level decreased by 0.9% per week as compared to 1.9% per week ( t-test, p = 0.004) in the women with term deliveries. From the cohort the course of S-relaxin during pregnancy in both preterm and term deliveries were fitted and graphed. S-relaxin level was raised in women who were hormonally stimulated to obtain pregnancy ( p = 0.0001), and lower in women with pre-pregnancy overweight (BMI ≥ 25, p = 0.01) as well as in women, who had previously been pregnant ( p = 0.008). A longitudinal adjusted model for the prediction of preterm delivery based on the change in S-relaxin was established. Conclusions S-relaxin levels decrease less rapidly in women who subsequently deliver preterm; this results in elevated S-relaxin levels in the second and the third trimesters.