Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days.

Autor:	Hermans FJR; Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands., Bruijn MMC; Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands., Vis JY; Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, the Netherlands., Wilms FF; Department of Obstetrics and Gynecology, University Hospital Maastricht, Maastricht, the Netherlands., Oudijk MA; Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands., Porath MM; Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands., Scheepers HCJ; Department of Obstetrics and Gynecology, University Hospital Maastricht, Maastricht, the Netherlands., Bloemenkamp KWM; Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands., Bax CJ; Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands., Cornette JMJ; Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands., Nij Bijvanck BWA; Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, the Netherlands., Franssen MTM; Department of Obstetrics and Gynecology, University Medical Center Groningen, Groningen, the Netherlands., Vandenbussche FPHA; Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands., Kok M; Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands., Grobman WA; Department of Gynecology and Obstetrics, Northwestern University Medical School, Chicago, IL, USA., Van Der Post JAM; Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands., Bossuyt PMM; Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, the Netherlands., Opmeer BC; Clinical Research Unit, Academic Medical Center, Amsterdam, the Netherlands., Mol BWJ; Robinson Research Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia., Schuit E; Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands.; Julius Center for Healthcare Research and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.; Stanford Prevention Research Center, Stanford University, Stanford, CA, USA., Van Baaren GJ; Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2015 Jul; Vol. 94 (7), pp. 715-721. Date of Electronic Publication: 2015 Apr 29.
DOI:	10.1111/aogs.12643
Abstrakt:	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. (© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.)
Databáze:	MEDLINE
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