Association Between Features of Spontaneous Late Preterm Labor and Late Preterm Birth.

Title

Association Between Features of Spontaneous Late Preterm Labor and Late Preterm Birth.

Creator

Glover AV; Battarbee AN; Gyamfi-Bannerman C; Boggess KA; Sandoval G; Blackwell SC; Tita ATN; Reddy UM; Jain L; Saade GR; Rouse DJ; Iams JD; Clark EAS; Chien EK; Peaceman AM; Gibbs RS; Swamy GK; Norton ME; Casey BM; Caritis SN; Tolosa JE; Sorokin Y; Manuck TA

Publisher

American Journal of Perinatology

Date

2020
2020-03

Description

OBJECTIVE: This study aimed to evaluate the association between clinical and examination features at admission and late preterm birth. STUDY DESIGN: The present study is a secondary analysis of a randomized trial of singleton pregnancies at 34(0/7) to 36(5/7) weeks' gestation. We included women in spontaneous preterm labor with intact membranes and compared them by gestational age at delivery (preterm vs. term). We calculated a statistical cut-point optimizing the sensitivity and specificity of initial cervical dilation and effacement at predicting preterm birth and used multivariable regression to identify factors associated with late preterm delivery. RESULTS: A total of 431 out of 732 (59%) women delivered preterm. Cervical dilation ≥ 4 cm was 60% sensitive and 68% specific for late preterm birth. Cervical effacement ≥ 75% was 59% sensitive and 65% specific for late preterm birth. Earlier gestational age at randomization, nulliparity, and fetal malpresentation were associated with late preterm birth. The final regression model including clinical and examination features significantly improved late preterm birth prediction (81% sensitivity, 48% specificity, area under the curve = 0.72, 95% confidence interval [CI]: 0.68-0.75, and p-value < 0.01). CONCLUSION: Four in 10 women in late-preterm labor subsequently delivered at term. Combination of examination and clinical features (including parity and gestational age) improved late-preterm birth prediction.

Subject

Humans; Pregnancy; Female; Risk Factors; Logistic Models; Infant Newborn; Sensitivity and Specificity; Prognosis; Gestational Age; Premature Birth; Glucocorticoids/administration & dosage; Pregnancy Trimester Third; Labor Stage First; Obstetric Labor Premature; Betamethasone/administration & dosage; Cervix Uteri; Parity; Respiratory Tract Diseases/prevention & control

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

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Pages

357-364

Issue

4

Volume

37

ISSN

1098-8785 0735-1631 0735-1631

Update Year & Number

Hospital List

Citation

Glover AV; Battarbee AN; Gyamfi-Bannerman C; Boggess KA; Sandoval G; Blackwell SC; Tita ATN; Reddy UM; Jain L; Saade GR; Rouse DJ; Iams JD; Clark EAS; Chien EK; Peaceman AM; Gibbs RS; Swamy GK; Norton ME; Casey BM; Caritis SN; Tolosa JE; Sorokin Y; Manuck TA, “Association Between Features of Spontaneous Late Preterm Labor and Late Preterm Birth.,” NEOMED Bibliography Database, accessed September 21, 2021, https://neomed.omeka.net/items/show/11456.

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