Fetus-Placenta-NewbornThe Preterm Prediction Study: Toward a multiple-marker test for spontaneous preterm birth☆,☆☆
Section snippets
Methods
The relationship between spontaneous preterm birth and many of the individual markers that were evaluated at 23 to 24 weeks in the Preterm Prediction Study have been presented previously.4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 Because of the large number of women in the original cohort (n = 2929), the large number of potential tests to be studied, and their costs, we originally planned to complete a nested case-control study of the tests after the major outcomes (such as
Results
Tables I and II show each of the factors included in the case-control analysis, the source of data or fluid from which the measurement was made, the cutoff value for a positive test, the percent of test results that were positive in the case patients and in the control subjects, and the crude odds ratio for spontaneous preterm birth at <32 weeks (Table I) and at <35 weeks (Table II).
Comment
To date, the potential benefits in improving pregnancy outcome by predicting spontaneous preterm birth have not been realized, principally because we have few, if any, effective interventions that can be used once high-risk status has been identified.2 As an example, it is now reasonably clear that the use of the demographic screening tests that focus on age, race, workload, and previous pregnancy outcomes, when used to identify women for various additional testing or interventions such as more
Acknowledgements
The authors acknowledge the participation of the following institutions and others who participated in the study: The University of Alabama at Birmingham (Rachel L. Copper, MSN, CRNP; John C. Hauth, MD; Allison Northen, RN); Wake Forest University (Allison Frye, RN; Eberhard Mueller-Heubach, MD; Melissa Swain, RN); University of Chicago (Phyllis Jones, MPH, RN; Marshall Lindheimer, MD); University of Cincinnati (Nancy Elder, MSN, RN; Tariq A. Siddiqi, MD); George Washington University, The
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Supported by the following grants from the National Institute of Child Health and Human Development (NICHD): HD21410, HC21414, HC21434, HD27860, HD27861, HD27869, HD27883, HD27889, HD27905, HD27915, HD27917, and HD19897.
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