الفهرس 
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Abstract
A birth is considered to be preterm when a woman gives birth before 37 completed weeks of gestation which is the most common cause for hospital admission of pregnant women (Romero R et al., 2017).
The origin of spontaneous preterm delivery is mostly unknown. However, infection and inflammation are leading causes, mainly at early gestational ages. Intrauterine infection occurs in 12-14% of symptomatic women with preterm labor and in 37-43% are due to premature rupture of membranes (PPROM) (Tsiartas P, 2017).
Serum ferritin ranges from 40 to 200 ng/mL is a measure of iron stores in healthy individuals, also ferritin is an acute phase protein so it is affected by inflammatory processes irrespective of the iron store (BabaeiM et al., 2017).
Cervicovaginal and serum ferritin were studied as predictors for preterm delivery. The study was conducted on 100 pregnant women with singleton pregnancies within 20-24 weeks of gestation at the department of obstetric and gynecology El Mehalla general hospital.
Full history, examination, ultrasound, CBC, serum and cervicovaginal ferritin levels were done to all the study group at 20-24 weeks. The gestational age at the time of delivery and the neonatal outcome were reported.
5cm venous blood samples were aspirated from cases using disposable plastic syringe after skin sterilization with ethyl alcohol swabs. A serum separator tube was used and samples were allowed to clot for 2 hours at room temperature before centrifugation for 20 minutes at approximately 1000×g. The supernatant was collected for assaying. Grossly haemolyzed samples were excluded.
A sample of mucous from the external os or the posterior fornix of the vagina was taken or sucked with a pipette before any other portion of pelvic examination was performed by using sterile speculum. They were centrifugated for 20 minutes at 1000×g to remove particulates. The supernatant was collected for assaying.
The samples (serum and cervicovaginal) were immediately placed in ependorf tubes then the ependorfs were placed in ice-box and transported to the laboratory where they stored at -20ºC and used within one month.
Samples were examined using ELIZA kits. Then, the optained data were statistically analysed.
There were two groups:
Term group: 85 pregnant women delivered 37:39 weeks.
Preterm group: 15 pregnant women delivered 33:36 weeks.
The serum and cervicovaginal ferritin levels showed high statistical significant differences with values of P<0.001 for both.
The ROC curve of serum ferritin in detection of preterm delivery, the cutoff point ≥110.5ng/ml carried sensitivity percent 86.7 and specificity percent 94.1.
The ROC curve of cervicovaginal ferritin in detection of preterm delivery, the cutoff point ≥25.5ng/ml carries sensitivity percent 86.7 and specificity percent 64.7.
There is strong positive correlation between both serum and cervicovaginal ferritin measuring 0.83.
Serum and cervicovaginal ferritin levels are significant predictors for preterm delivery as an increase by one unit of serum ferritin level increases the preterm delivery risk by 1.277 and an increase by one unit of cervicovaginal ferritin level increases the preterm delivery risk by 1.108.
85% of preterm delivery can be predicted by serum and cervicovaginal ferritin levels when measured in midgestation (20-24ws).