Early prediction of preterm birth for singleton, twin, and triplet pregnancies.

OBJECTIVES To create prediction models of early preterm birth for singletons, twin, and triplet pregnancies. STUDY DESIGN We used a historical cohort study with the 1996 birth registration data for singletons and the 1995-1997 linked birth/infant death dataset for multiple births of the United States. Preterm birth was defined as gestational age <32 completed weeks. Eligible study subjects were randomly allocated to two groups: one group (80% subjects) for the creation of the prediction models, and the other group (20% subjects) for the validation of the established prediction models. Multivariate logistic regressions were used to establish the prediction models. We further assessed the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the established prediction models with different cut-off values in the validation group. RESULTS The sensitivity, specificity, PPV, and NPV of the established model were 24.58, 93.54, 5.91, and 98.69%, respectively for singletons, 64.66, 57.04, 16.29, and 92.59%, respectively for twins, and 63.57, 53.58, 42.96, and 72.78%, respectively for triplets. CONCLUSION The prediction models of early preterm birth for singleton, twin, and triplet pregnancies created by this study could be useful for obstetricians to identify women being at high risk of preterm birth at early gestation.

[1]  A. Moawad,et al.  Maternal age and preterm births in a black population. , 2000, Paediatric and perinatal epidemiology.

[2]  W. E. Hammond,et al.  Data Mining Methods Find Demographic Predictors of Preterm Birth , 2001, Nursing research.

[3]  P. Meis,et al.  What we have learned about the predictors of preterm birth. , 2003, Seminars in perinatology.

[4]  R. Goldenberg,et al.  The management of preterm labor. , 2002, Obstetrics and gynecology.

[5]  H. Wolfe,et al.  Patients with an ultrasonographic cervical length < or =15 mm have nearly a 50% risk of early spontaneous preterm delivery. , 2000, American journal of obstetrics and gynecology.

[6]  M A Morgan,et al.  Prediction of delivery among women with early preterm labor by means of clinical characteristics alone. , 1999, American journal of obstetrics and gynecology.

[7]  D. Strobino,et al.  Annual summary of vital statistics--2001. , 2002, Pediatrics.

[8]  R. H. Holbrook,et al.  Evaluation of a risk-scoring system for prediction of preterm labor. , 1989, American journal of perinatology.

[9]  R. Newman,et al.  Preterm birth risk assessment. , 2001, Seminars in perinatology.

[10]  R. Mesleh,et al.  Changing trends in perinatal deaths at the Armed Forces Hospital, Riyadh, Saudi Arabia. , 2001, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[11]  E. Thom,et al.  The preterm prediction study: significance of vaginal infections. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. , 1995, American journal of obstetrics and gynecology.

[12]  H. Rydhstroem,et al.  Gestational duration, and fetal and infant mortality for twins vs singletons. , 2001 .

[13]  G. Alexander,et al.  Prematurity at birth: trends, racial disparities, and epidemiology. , 2002, Mental retardation and developmental disabilities research reviews.

[14]  M. Hannah,et al.  Fetal Fibronectin as a Predictor of Preterm Birth: An Overview , 1998, American journal of perinatology.

[15]  J. Kleijnen,et al.  Accuracy of cervical transvaginal sonography in predicting preterm birth: a systematic review , 2003 .

[16]  S. Kirkland,et al.  Risk scoring, fetal fibronectin, and bacterial vaginosis to predict preterm delivery. , 1999, Obstetrics and gynecology.

[17]  R. Goldenberg,et al.  Evaluation of a risk scoring system as a predictor of preterm birth in an indigent population. , 1990, American journal of obstetrics and gynecology.

[18]  Lucas M Bachmann,et al.  Accuracy of cervicovaginal fetal fibronectin test in predicting risk of spontaneous preterm birth: systematic review , 2002, BMJ : British Medical Journal.

[19]  A. Fanaroff,et al.  Outcomes of children of extremely low birthweight and gestational age in the 1990's. , 1999, Early human development.

[20]  Elizabeth A Thom,et al.  Frequency of uterine contractions and the risk of spontaneous preterm delivery. , 2002, The New England journal of medicine.

[21]  T. Nas,et al.  Are sociodemographic factors predictive of preterm birth? A reappraisal of the 1958 British Perinatal Mortality Survey , 1997, British journal of obstetrics and gynaecology.