TY - JOUR
T1 - Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days
AU - Hermans, Frederik J.R.
AU - Bruijn, Merel M.C.
AU - Vis, Jolande Y.
AU - Wilms, Femke F.
AU - Oudijk, Martijn A.
AU - Porath, Martina M.
AU - Scheepers, Hubertina C.J.
AU - Bloemenkamp, Kitty W.M.
AU - Bax, Caroline J.
AU - Cornette, Jérôme M.J.
AU - Nij Bijvanck, Bas W.A.
AU - Franssen, Maureen T.M.
AU - Vandenbussche, Frank P.H.A.
AU - Kok, Marjolein
AU - Grobman, William A.
AU - Van Der Post, Joris A.M.
AU - Bossuyt, Patrick M.M.
AU - Opmeer, Brent C.
AU - Mol, Ben Willem J.
AU - Schuit, Ewoud
AU - Van Baaren, Gert Jan
PY - 2015/7/1
Y1 - 2015/7/1
N2 - 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.
AB - 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.
KW - cervical length
KW - fetal fibronectin
KW - prediction
KW - pregnancy complications
KW - risk
KW - spontaneous preterm delivery
KW - Threatened preterm labor
UR - http://www.scopus.com/inward/record.url?scp=84930418156&partnerID=8YFLogxK
U2 - 10.1111/aogs.12643
DO - 10.1111/aogs.12643
M3 - Article
C2 - 25845495
AN - SCOPUS:84930418156
SN - 0001-6349
VL - 94
SP - 715
EP - 721
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
IS - 7
ER -