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Prediction of preterm labour from a single blood test: The role of the endocannabinoid system in predicting preterm birth in high-risk women

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posted on 27.03.2020, 10:11 by P Bachkangi, AH Taylor, Monica Bari, Mauro Maccarrone, Justin C Konje
Objective: To determine if plasma concentrations of the N-acylethanolamines (NAEs) N-arachidonoylethanolamine (AEA), N-oleoylethanolamide (OEA) and N-palmitoylethanolamide (PEA) increase in women at high risk for preterm birth (PTB) and whether these could be used to predict preterm delivery and if so, how they compare with current methods. Design: Prospective cohort study. Setting: A large UK teaching hospital. Population: 217 pregnant women were recruited between 24 and 34 gestational weeks at ‘high-risk’ for PTB, recruited from a prematurity prevention clinic or antenatal wards. Methods: Plasma AEA, OEA, and PEA concentrations were measured using ultra-high performance liquid chromatography-tandem mass spectrometry whilst FAAH enzyme activity was measured by fluorometric radiometric assay and CL by ultrasound scan. The clinical usefulness of these measurements were determined by ROC and multivariate analyses. Results: AEA and PEA concentrations were significantly higher in women who delivered prematurely. An AEA concentration >1.095 nM predicted PTB, the gestational age at delivery and the recruitment to delivery interval (RTDI). A PEA concentration >17.50 nM only predicted PTB; FAAH enzyme activity was not related to these changes. Multivariate analysis (all variables) generated an equation to accurately predict the RTDI. Conclusions: A single plasma AEA or PEA measurement can predict PTB. A single AEA measurement predicts the gestational age of delivery and the remaining period of pregnancy with reasonable accuracy and better than existing conventional tests thus offering a better window for primary prevention of PTB.

Funding

This work was funded by the University Hospitals of Leicester and the MRCOG Part II Revision Course run by Professor Konje.

History

Citation

P. Bachkangi, A.H. Taylor, Monica Bari, Mauro Maccarrone, Justin C. Konje, Prediction of preterm labour from a single blood test: The role of the endocannabinoid system in predicting preterm birth in high-risk women, European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 243, 2019, Pages 1-6,

Version

AM (Accepted Manuscript)

Published in

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY

Volume

243

Pagination

1 - 6 (6)

Publisher

ELSEVIER

issn

0301-2115

eissn

1872-7654

Acceptance date

30/09/2019

Copyright date

2019

Available date

01/10/2019

Publisher version

https://www.sciencedirect.com/science/article/pii/S0301211519304427

Spatial coverage

Ireland

Language

English