Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth

Angelica V. Glover; Ashley N. Battarbee; Cynthia Gyamfi-Bannerman; Kim A. Boggess; Grecio Sandoval; Sean C. Blackwell; Alan T.N. Tita; Uma M. Reddy; Lucky Jain; George R. Saade; Dwight J. Rouse; Jay D. Iams; Erin A.S. Clark; Edward K. Chien; Alan M. Peaceman; Ronald S. Gibbs; Geeta K. Swamy; Mary E. Norton; Brian M. Casey; Steve N. Caritis; Jorge E. Tolosa; Yoram Sorokin; Tracy A. Manuck

doi:10.1055/s-0039-1696641

Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth

Angelica V. Glover^*, Ashley N. Battarbee, Cynthia Gyamfi-Bannerman, Kim A. Boggess, Grecio Sandoval, Sean C. Blackwell, Alan T.N. Tita, Uma M. Reddy, Lucky Jain, George R. Saade, Dwight J. Rouse, Jay D. Iams, Erin A.S. Clark, Edward K. Chien, Alan M. Peaceman, Ronald S. Gibbs, Geeta K. Swamy, Mary E. Norton, Brian M. Casey, Steve N. CaritisJorge E. Tolosa, Yoram Sorokin, Tracy A. Manuck

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English (US)
Pages (from-to)	357-364
Number of pages	8
Journal	American journal of perinatology
Volume	37
Issue number	4
DOIs	https://doi.org/10.1055/s-0039-1696641
State	Published - Mar 1 2020

Funding

We performed all statistical analyses using STATA/SE, Version 14.1 (StataCorp, Inc., College Station, TX). p-Value < 0.05 was considered statistically significant. All women provided written, informed consent for the original trial at their local center. We performed this secondary analysis using a deidentified dataset under a waiver of informed consent approved by the Institutional Review Board at the University of North Carolina at Chapel Hill. This study was supported by grants (HL098554 and HL098354) from the National Heart, Lung, and Blood Institute (NHLBI), by grants (HD21410, HD27915, HD27917, HD27869, HD34116, HD34208, HD40485, HD40500, HD40512, HD40544, HD40545, HD40560, HD53097, HD53118, HD68268, HD68258, HD68282, and HD36801) from the National Institute of Child This study was supported by grants (HL098554 and HL098354) from the NHLBI, by grants (HD21410, HD27915, HD27917, HD27869, HD34116, HD34208, HD40485, HD40500, HD40512, HD40544, HD40545, HD40560, HD53097, HD53118, HD68268, HD68258, HD68282, and HD36801) from the NICHD, and by a grant (UL1 TR000040) from the National Center for Advancing Translational Sciences, National Institutes of Health. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Institutes of Health. Health and Human Development (NICHD), and by a grant (UL1 TR000040) from the National Center for Advancing Translational Sciences, National Institutes of Health.

Keywords

ALPS
late preterm birth
prediction
preterm labor
spontaneous labor

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

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10.1055/s-0039-1696641

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Glover, A. V., Battarbee, A. N., Gyamfi-Bannerman, C., Boggess, K. A., Sandoval, G., Blackwell, S. C., Tita, A. T. N., Reddy, U. M., Jain, L., Saade, G. R., Rouse, D. J., Iams, J. D., Clark, E. A. S., Chien, E. K., Peaceman, A. M., Gibbs, R. S., Swamy, G. K., Norton, M. E., Casey, B. M., ... Manuck, T. A. (2020). Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth. American journal of perinatology, 37(4), 357-364. https://doi.org/10.1055/s-0039-1696641

@article{b8888e69d7bb4f79978ffaf71a2a2a76,

title = "Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth",

abstract = "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.",

keywords = "ALPS, late preterm birth, prediction, preterm labor, spontaneous labor",

author = "Glover, {Angelica V.} and Battarbee, {Ashley N.} and Cynthia Gyamfi-Bannerman and Boggess, {Kim A.} and Grecio Sandoval and Blackwell, {Sean C.} and Tita, {Alan T.N.} and Reddy, {Uma M.} and Lucky Jain and Saade, {George R.} and Rouse, {Dwight J.} and Iams, {Jay D.} and Clark, {Erin A.S.} and Chien, {Edward K.} and Peaceman, {Alan M.} and Gibbs, {Ronald S.} and Swamy, {Geeta K.} and Norton, {Mary E.} and Casey, {Brian M.} and Caritis, {Steve N.} and Tolosa, {Jorge E.} and Yoram Sorokin and Manuck, {Tracy A.}",

year = "2020",

month = mar,

day = "1",

doi = "10.1055/s-0039-1696641",

language = "English (US)",

volume = "37",

pages = "357--364",

journal = "American journal of perinatology",

issn = "0735-1631",

publisher = "Thieme Medical Publishers, Inc.",

number = "4",

}

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 2020, 'Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth', American journal of perinatology, vol. 37, no. 4, pp. 357-364. https://doi.org/10.1055/s-0039-1696641

TY - JOUR

T1 - Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth

AU - Glover, Angelica V.

AU - Battarbee, Ashley N.

AU - Gyamfi-Bannerman, Cynthia

AU - Boggess, Kim A.

AU - Sandoval, Grecio

AU - Blackwell, Sean C.

AU - Tita, Alan T.N.

AU - Reddy, Uma M.

AU - Jain, Lucky

AU - Saade, George R.

AU - Rouse, Dwight J.

AU - Iams, Jay D.

AU - Clark, Erin A.S.

AU - Chien, Edward K.

AU - Peaceman, Alan M.

AU - Gibbs, Ronald S.

AU - Swamy, Geeta K.

AU - Norton, Mary E.

AU - Casey, Brian M.

AU - Caritis, Steve N.

AU - Tolosa, Jorge E.

AU - Sorokin, Yoram

AU - Manuck, Tracy A.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - 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.

AB - 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.

KW - ALPS

KW - late preterm birth

KW - prediction

KW - preterm labor

KW - spontaneous labor

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UR - http://www.scopus.com/inward/citedby.url?scp=85081091574&partnerID=8YFLogxK

U2 - 10.1055/s-0039-1696641

DO - 10.1055/s-0039-1696641

M3 - Article

C2 - 31529452

AN - SCOPUS:85081091574

SN - 0735-1631

VL - 37

SP - 357

EP - 364

JO - American journal of perinatology

JF - American journal of perinatology

IS - 4

ER -

Association between Features of Spontaneous Late Preterm Labor and Late Preterm Birth

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