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

Frederik J.R. Hermans*, Merel M.C. Bruijn, Jolande Y. Vis, Femke F. Wilms, Martijn A. Oudijk, Martina M. Porath, Hubertina C.J. Scheepers, Kitty W.M. Bloemenkamp, Caroline J. Bax, Jérôme M.J. Cornette, Bas W.A. Nij Bijvanck, Maureen T.M. Franssen, Frank P.H.A. Vandenbussche, Marjolein Kok, William A Grobman, Joris A.M. Van Der Post, Patrick M.M. Bossuyt, Brent C. Opmeer, Ben Willem J. Mol, Ewoud SchuitGert Jan Van Baaren

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)715-721
Number of pages7
JournalActa Obstetricia et Gynecologica Scandinavica
Volume94
Issue number7
DOIs
StatePublished - Jan 1 2015

Keywords

  • Threatened preterm labor
  • cervical length
  • fetal fibronectin
  • prediction
  • pregnancy complications
  • risk
  • spontaneous preterm delivery

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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