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The preterm prediction study: The value of new vs standard risk factors in predicting early and all spontaneous preterm births

Author

Listed:
  • Goldenberg, R.L.
  • Iams, J.D.
  • Mercer, B.M.
  • Meis, P.J.
  • Moawad, A.H.
  • Copper, R.L.
  • Das, A.
  • Thom, E.
  • Johnson, F.
  • McNellis, D.
  • Miodovnik, M.
  • Van Dorsten, J.P.
  • Caritis, S.N.
  • Thurnau, G.R.
  • Bottoms, S.F.

Abstract

Objective. 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 of 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.

Suggested Citation

  • Goldenberg, R.L. & Iams, J.D. & Mercer, B.M. & Meis, P.J. & Moawad, A.H. & Copper, R.L. & Das, A. & Thom, E. & Johnson, F. & McNellis, D. & Miodovnik, M. & Van Dorsten, J.P. & Caritis, S.N. & Thurnau,, 1998. "The preterm prediction study: The value of new vs standard risk factors in predicting early and all spontaneous preterm births," American Journal of Public Health, American Public Health Association, vol. 88(2), pages 233-238.
    • Handle: RePEc:aph:ajpbhl:1998:88:2:233-238_0
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    Cited by:

    1. Daniel Kim & Adrianna Saada, 2013. "The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review," IJERPH, MDPI, vol. 10(6), pages 1-40, June.
    2. Paul, Kathleen & Garcia, Pedro J. & Manhart, Lisa E. & Holmes, King K. & Hitti, Jane E., 2009. "Partner- and partnership-related risk factors for preterm birth among low-income women in Lima, Peru," Social Science & Medicine, Elsevier, vol. 68(8), pages 1535-1540, April.
    3. Kramer, Michael R. & Cooper, Hannah L. & Drews-Botsch, Carolyn D. & Waller, Lance A. & Hogue, Carol R., 2010. "Metropolitan isolation segregation and Black-White disparities in very preterm birth: A test of mediating pathways and variance explained," Social Science & Medicine, Elsevier, vol. 71(12), pages 2108-2116, December.
    4. Iker Malaina & Luis Martinez & Roberto Matorras & Carlos Bringas & Larraitz Aranburu & Luis Fernández-Llebrez & Leire Gonzalez & Itziar Arana & Martín-Blas Pérez & Ildefonso Martínez de la Fuente, 2017. "Estimation of preterm labor immediacy by nonlinear methods," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-16, June.
    5. Paul, Kathleen & Boutain, Doris & Manhart, Lisa & Hitti, Jane, 2008. "Racial disparity in bacterial vaginosis: the role of socioeconomic status, psychosocial stress, and neighborhood characteristics, and possible implications for preterm birth," Social Science & Medicine, Elsevier, vol. 67(5), pages 824-833, September.

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