Intercellular Adhesion Molecule-1 (ICAM-1) in Cervicovaginal Fluid of Women Presenting with Preterm Labor: Predictive Value for Preterm Delivery

PROBLEM: Clinically useful tests for the prediction and diagnosis of preterm labor and delivery remain to be established. We have hypothesized that soluble intercellular adhesion molecule‐1 (sICAM‐1) in the cervicovaginal fluid of women with preterm labor may be a useful diagnostic tool. METHOD OF STUDY: The cervicovaginal fluid of 103 women between 240 and 336 weeks gestation with preterm contractions and intact membranes was assayed for sICAM‐1. RESULTS: Elevated sICAM‐1 concentrations predicted short intervals to delivery (area under receiver–operator characteristic (ROC) curves, 0.70–0.72 for delivery within 3, 7 and 10 days), with high specificity. Characteristics for delivery within 3 days at a 3 ng/mL threshold for a positive test were sensitivity 33.3%, specificity 98.9%, and positive and negative predictive values of 75.0% and 93.9%, respectively. Predictive ability was independent of and complementary to that of fetal fibronectin (fFN). CONCLUSIONS: Measurement of sICAM‐1 in cervicovaginal fluid has potential as a predictor of preterm delivery in women with symptoms of preterm labor, particularly in conjunction with fFN testing.