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- Title
Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days.
- Authors
Hermans, Frederik J.R.; Bruijn, Merel M.C.; Vis, Jolande Y.; Wilms, Femke F.; Oudijk, Martijn A.; Porath, Martina M.; Scheepers, Hubertina C.J.; Bloemenkamp, Kitty W.M.; Bax, Caroline J.; Cornette, Jérôme M.J.; Nij Bijvanck, Bas W.A.; Franssen, Maureen T.M.; Vandenbussche, Frank P.H.A.; Kok, Marjolein; Grobman, William A.; Van Der Post, Joris A.M.; Bossuyt, Patrick M.M.; Opmeer, Brent C.; Mol, Ben Willem J.; Schuit, Ewoud
- Abstract
Objective To stratify the risk of spontaneous preterm delivery using cervical length ( CL) and fetal fibronectin ( fFN) in women with threatened preterm labor who remained pregnant after 7 days. Design Prospective observational study. Setting Nationwide cohort of women with threatened preterm labor from the Netherlands. Population Women with threatened preterm labor between 24 and 34 weeks with a valid CL and fFN measurement and remaining pregnant 7 days after admission. Methods Kaplan-Meier and Cox proportional hazards models were used to estimate cumulative percentages and hazard ratios ( HR) for spontaneous delivery. Main outcome measures Spontaneous delivery between 7 and 14 days after initial presentation and spontaneous preterm delivery before 34 weeks. Results The risk of delivery between 7 and 14 days was significantly increased for women with a CL < 15 mm or a CL ≥15 to <30 mm and a positive fFN, compared with women with a CL ≥30 mm: HR 22.3 [95% confidence interval ( CI) 2.6-191] and 14 (95% CI 1.8-118), respectively. For spontaneous preterm delivery before 34 weeks the risk was increased for women with a CL < 15 mm [ HR 6.3 (95% CI 2.6-15)] or with a CL ≥15 to <30 mm with either positive fFN [ HR 3.6 (95% CI 1.5-8.7)] or negative fFN [ HR 3.0 (95% CI 1.2-7.1)] compared with women with a CL ≥ 30 mm. Conclusions In women remaining pregnant 7 days after threatened preterm labor, CL and fFN results can be used in risk stratification for spontaneous delivery.
- Subjects
NETHERLANDS; FIBRONECTINS; PREMATURE labor; MATERNAL health; KAPLAN-Meier estimator
- Publication
Acta Obstetricia et Gynecologica Scandinavica, 2015, Vol 94, Issue 7, p715
- ISSN
0001-6349
- Publication type
Article
- DOI
10.1111/aogs.12643