Complement Activation During Early Pregnancy and Clinical Predictors of Preterm Birth in African American Women.
Alexis B Dunn, Anne L Dunlop, Andrew H Miller and 3 others
PMID 31651632WHAT IT FOUND
Early pregnancy complement markers C3a and Bb did not predict 20-week cervical length or delivery timing in 144 African American women.
Prior preterm birth and Medicaid insurance were linked to shorter cervical length.
Key findings
01In the full cohort, early pregnancy complement markers C3a and Bb were not significant independent predictors of 20-week cervical length or gestational age at delivery.
02A previous history of preterm birth was associated with a cervical length 0.59 cm shorter in the full cohort model.
03In multiparous women, private insurance was associated with a cervical length 0.91 cm longer than Medicaid insurance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study enrolled relatively healthy pregnant women and excluded chronic illness and anti-inflammatory or antibiotic use, so the findings may not apply to women with conditions that could drive exaggerated inflammation. Only two complement markers were measured, so other parts of the complement pathway were not assessed. The sample was small for subgroup analyses, especially only 40 women with spontaneous labor onset in each parity group. There were only 5 women with a clinically shortened cervix, so that high-risk group could not be examined separately. Laboratory variability was slightly elevated for C3a and Bb measurements, which could have affected the results. The study is observational and reports associations, not effects of treatment or care. The nursing education and care-coordination suggestions are not tested outcomes in this paper.
The easy way to misread this
Do not conclude that C3a or Bb levels can identify African American women at risk for preterm birth. The markers were not significant predictors of cervical length or gestational age, and the subgroup analyses were small.