Predictive Factors for Delivery within 7 Days after Successful 48-Hour Treatment of Threatened Preterm Labor

• Published in: American journal of perinatology reports Vol. 5; no. 2; pp. e141 - e149
• Main Authors: Roos, Carolien, Schuit, Ewoud, Scheepers, Hubertina C. J., Bloemenkamp, Kitty W. M., Bolte, Antoinette C., Duvekot, Hans J. J., van Eyck, Jim, Kok, Joke H., Kwee, Anneke, Merién, Ashley E. R., Opmeer, Brent C., Oudijk, Martijn A., van Pampus, Mariëlle G., Papatsonis, Dimitri N. M., Porath, Martina M., Sollie, Krystyna M., Spaanderman, Marc E. A., Vijgen, Sylvia M. C., Willekes, Christine, Lotgering, Fred K., van der Post, Joris A. M., Mol, Ben Willem J.
• Format: Journal Article
• Language: English
• Published: 333 Seventh Avenue, New York, NY 10001, USA Thieme Medical Publishers 01.10.2015; Thieme Medical Publishers, Inc
• Subjects: Case Report; maintenance tocolysis; predictive factors; preterm delivery; maintenance tocolysis; preterm delivery; predictive factors
• ISSN: 2157-6998; 2157-7005
• DOI: 10.1055/s-0035-1552930

Abstract Objective  The aim of this study was to assess which characteristics and results of vaginal examination are predictive for delivery within 7 days, in women with threatened preterm labor after initial treatment. Study Design  A secondary analysis of a randomized controlled trial on maintenance nifedipine includes women who remained undelivered after threatened preterm labor for 48 hours. We developed one model for women with premature prelabor rupture of membranes (PPROM) and one without PPROM. The predictors were identified by backward selection. We assessed calibration and discrimination and used bootstrapping techniques to correct for potential overfitting. Results  For women with PPROM (model 1), nulliparity, history of preterm birth, and vaginal bleeding were included in the multivariable analysis. For women without PPROM (model 2), maternal age, vaginal bleeding, cervical length, and fetal fibronectin (fFN) status were in the multivariable analysis. Discriminative capability was moderate to good ( c -statistic 0.68; 95% confidence interval [CI] 0.60–0.77 for model 1 and 0.89; 95% CI, 0.84–0.93 for model 2). Conclusion  PPROM and vaginal bleeding in the current pregnancy are relevant predictive factors in all women, as are maternal age, cervical length, and fFN in women without PPROM and nulliparity, history of preterm birth in women with PPROM.