The preterm prediction study: the value of new vs standard risk factors in predicting early and all spontaneous preterm births. NICHD MFMU Network.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print Cited Medium: Print ISSN: 0090-0036 (Print) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

Infant, Premature*; Obstetric Labor, Premature/*epidemiology; Cervix Uteri/anatomy & histology ; Female ; Fetal Blood ; Fibronectins/blood ; Gestational Age ; Humans ; Infant, Newborn ; Logistic Models ; Pregnancy ; Risk Factors ; United States/epidemiology ; Vaginosis, Bacterial

Objectives: This study was undertaken to determine the relationship between fetal fibronectin, short cervix, bacterial vaginosis, other traditional risk factors, and spontaneous preterm birth.
Methods: From 1992 through 1994, 2929 women were screened at the gestational age 22 to 24 weeks.
Results: The odds ratios for spontaneous preterm birth were highest for fetal fibronectin, followed by a short cervix and history of preterm birth. These factors, as well as bacterial vaginosis, were more strongly associated with early than with late spontaneous preterm birth. Bacterial vaginosis was more common--and a stronger predictor of spontaneous preterm birth--in Black women, while body mass index less than 19.8 was a stronger predictor in non-Black women. This analysis suggests a pathway leading from Black race through bacterial vaginosis and fetal fibronectin to spontaneous preterm birth. Prior preterm birth is associated with spontaneous preterm birth through a short cervix.
Conclusions: Fetal fibronectin and a short cervix are stronger predictors of spontaneous preterm birth than traditional risk factors. Bacterial vaginosis was found more often in Black than in non-Black women and accounted for 40% of the attributable risk for spontaneous preterm birth at less than 32 weeks.

Comment in: Am J Public Health. 1998 Feb;88(2):183-4. (PMID: 9491003)

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HD21410 United States HD NICHD NIH HHS; HD21414 United States HD NICHD NIH HHS; HD21434 United States HD NICHD NIH HHS

0 (Fibronectins)

Date Created: 19980310 Date Completed: 19980311 Latest Revision: 20190514

20240829

PMC1508185

10.2105/ajph.88.2.233

9491013