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Title: Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage
Authors: Lek, Sze Min
Ku, Chee Wai
Allen Jr, John C.
Malhotra, Rahul
Tan, Nguan Soon
Østbye, Truls
Tan, Thiam Chye
Keywords: Cut-off Level
DRNTU::Science::Biological sciences
Issue Date: 2017
Source: Lek, S. M., Ku, C. W., Allen Jr, J. C., Malhotra, R., Tan, N. S., Østbye, T., & Tan, T. C. (2017). Validation of serum progesterone <35nmol/L as a predictor of miscarriage among women with threatened miscarriage. BMC Pregnancy and Childbirth, 17(1), 78-. doi: 10.1186/s12884-017-1261-4
Series/Report no.: BMC Pregnancy and Childbirth
Abstract: Background: Our recent paper, based on a pilot cohort of 119 women, showed that serum progesterone <35 nmol/L was prognostic of spontaneous miscarriage by 16 weeks in women with threatened miscarriage in early pregnancy. Using a larger cohort of women from the same setting (validation cohort), we aim to assess the validity of serum progesterone <35 nmol/L with the outcome of spontaneous miscarriage by 16 weeks. Methods: In a prospective cohort study, 360 pregnant women presenting with threatened miscarriage between gestation weeks 6–10 at a tertiary hospital emergency unit for women in Singapore were recruited for this study. The main outcome measure measured is spontaneous miscarriage prior to week 16 of gestation. Area under the ROC curve (AUC) and test characteristics (sensitivity, specificity, positive and negative predictive value) at a serum progesterone cutpoint of <35 nmol/L for predicting high and low risk of spontaneous miscarriage by 16 weeks were compared between the Pilot and Validation cohorts. Results: Test characteristics and AUC values using serum progesterone <35 nmol/L in the validation cohort were not significantly different from those in the Pilot cohort, demonstrating excellent accuracy and reproducibility of the proposed serum progesterone cut-off level. Conclusions: The cut-off value for serum progesterone (35 nmol/L) demonstrated clinical relevance and allow clinicians to stratify patients into high and low risk groups for spontaneous miscarriage.
DOI: 10.1186/s12884-017-1261-4
Rights: © 2017 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:SBS Journal Articles

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