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A Preconception Nomogram to Predict Preterm Delivery.

Shilpi S Mehta-Lee1, Anton Palma2, Peter S Bernstein3

  • 1Maternal Fetal Care Center, Department of Obstetrics and Gynecology, NYU/Langone Medical Center, 150 East 32nd St., Suite 101, New York, NY, 10016, USA. Shilpi.Mehta-Lee@nyumc.org.

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|July 28, 2016
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Summary
This summary is machine-generated.

This study developed a preconception nomogram to identify women at high risk for preterm birth. The tool uses factors like prior preterm birth and diabetes to predict risk, aiding early intervention.

Keywords:
NomogramPRAMSPrediction toolPreterm birth

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Health
  • Public Health Surveillance

Background:

  • Preterm birth is a major cause of infant mortality and morbidity.
  • Current prevention strategies often overlook the crucial role of preconception care.
  • Identifying at-risk women before pregnancy is essential for effective preterm birth prevention.

Purpose of the Study:

  • To develop a predictive tool, a preconception nomogram, for identifying non-pregnant women at high risk of preterm birth.
  • To utilize the Pregnancy Risk Assessment Monitoring System (PRAMS) data for creating and validating this risk assessment tool.
  • To enable targeted preconception care interventions for women identified as high-risk.

Main Methods:

  • Analysis of PRAMS surveillance data from 2004 to 2009, including 192,208 cases.
  • Estimation of odds ratios (ORs) for preterm birth associated with various preconception variables.
  • Development and validation of a multivariate logistic regression model to create a preterm birth prediction nomogram.

Main Results:

  • Significant predictors of preterm birth included: prior preterm birth history, prior abortion, pre-conception diabetes, non-Hispanic Black race, pregnancy intention, and smoking.
  • The final preconception risk model demonstrated good classification accuracy (76.1%) and a negative predictive value of 76.7%.
  • A validated nomogram on a 0-100 scale was created to illustrate individual preterm birth risk.

Conclusions:

  • The developed preconception nomogram serves as a valuable clinical tool for predicting individual preterm birth risk in non-pregnant women.
  • It facilitates the triage of high-risk women to essential preconception care services.
  • Further clinical validation of the nomogram is recommended to confirm its utility in practice.