Open AccessRisk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days
Author(s) -
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,
Van Baaren GertJan
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12643
Subject(s) - fetal fibronectin , medicine , hazard ratio , confidence interval , obstetrics , proportional hazards model , prospective cohort study , preterm delivery , gynecology , cohort study , pregnancy , fetus , surgery , biology , genetics
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.