A proposed method to predict preterm birth using clinical data, standard maternal serum screening, and cholesterol - 30/05/13
, Kristi S. Borowski, MD b
Reprints: Jeffrey C. Murray, MD, University of Iowa, 500 Newton Rd., 2182 ML, Iowa City, IA 52242.Abstract |
Objective |
The objective of the study was to create a predictive model for preterm birth (PTB) from available clinical data and serum analytes.
Study Design |
Serum analytes and routine pregnancy screening plus cholesterol and corresponding health information were linked to birth certificate data for a cohort of 2699 Iowa women with serum sampled in the first and second trimester. Stepwise logistic regression was used to select the best predictive model for PTB.
Results |
Serum screening markers remained significant predictors of PTB, even after controlling for maternal characteristics. The best predictive model included maternal characteristics, first-trimester total cholesterol, total cholesterol change between trimesters, and second-trimester alpha-fetoprotein and inhibin A. The model showed better discriminatory ability than PTB history alone and performed similarly in subgroups of women without past PTB.
Conclusion |
Using clinical and serum screening data, a potentially useful predictor of PTB was constructed. Validation and replication in other populations, and incorporation of other measures that identify PTB risk, like cervical length, can be a step toward identifying additional women who may benefit from new or currently available interventions.
Le texte complet de cet article est disponible en PDF.Key words : cholesterol, prediction, preterm birth, serum screening
Plan
| Supported by Bill and Melinda Gates Millennium grants OPP52256 and RSDP 5K12 HD-000849-23, National Institutes of Health grants R01 HD-57192 and R01 HD-52953, University of Iowa Medical Scientist Training Program grant T325GM007337 University of Iowa Clinical and Translational Science Award grants 2 UL1 TR000442-06, and March of Dimes grants 6-FY11-261 and 11-FY10-180. |
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| The authors report no conflict of interest. |
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| Cite this article as: Alleman BW, Smith AR, Byers HM, et al. A proposed method to predict preterm birth using clinical data, standard maternal serum screening, and cholesterol. Am J Obstet Gynecol 2013;208:472.e1-11. |
Vol 208 - N° 6
P. 472.e1-472.e11 - juin 2013 Retour au numéro
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