Related Experiment Video
Updated: Jun 24, 2026
14:43
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
"Actionable" risk for preterm birth: patterns and prediction in California singleton births 2016-2020
Laura L Jelliffe-Pawlowski1,2,3,4,5,6,7,8, Rebecca J Baer9,10,11,12,13,14,15,16, Scott Oltman17,18,19,11,12
1Rory Meyers College of Nursing, New York University, New York, NY, USA. LJ2596@nyu.edu.
BMC Pregnancy and Childbirth
|June 23, 2026
Summary
The PTB-ARIx identifies pregnant individuals at high risk for preterm birth (PTB) and adverse outcomes. This tool focuses on modifiable risks, aiding early intervention and improving patient-provider communication for equitable care.
Area of Science:
- Maternal-fetal medicine
- Public health
- Health informatics
Background:
- Preterm birth (PTB) is a leading cause of infant mortality in the U.S., with rising rates linked to maternal conditions like hypertension and diabetes.
- Existing evidence-based interventions for maternal risk factors are underutilized, highlighting gaps in care.
- The PTB Actionable Risk Index (PTB-ARIx) was developed to identify pregnant individuals at increased risk for PTB by focusing on factors with available interventions.
Purpose of the Study:
- To evaluate the performance of the PTB-ARIx in determining PTB risk throughout pregnancy.
- To characterize actionable risk factors and their combined contribution to PTB.
- To assess the PTB-ARIx's effectiveness across different PTB subtypes and demographic subgroups.
Main Methods:
- A retrospective cohort study analyzed linked data from 1.9 million singleton live births in California (2016-2020).
- Poisson regression was used to assess associations between 18 risk factors (clinical, behavioral, social) and PTB.
- The PTB-ARIx was constructed using beta coefficients and evaluated using area under the receiver operating characteristic curve (AUC).
Main Results:
- Preeclampsia risk factors showed the strongest association with PTB (RR 6.73).
- Each unit increase in PTB-ARIx correlated with over 60% higher PTB risk (RRs 1.66-1.72).
- The PTB-ARIx demonstrated strong performance for early PTB (AUC 0.69-0.72) and very high performance for early PTB with preeclampsia (AUC up to 0.97).
Conclusions:
- The PTB-ARIx is a high-performing metric for identifying individuals at risk for PTB and other adverse pregnancy outcomes.
- By focusing on modifiable risks, the PTB-ARIx facilitates intervention opportunities and can improve patient-provider communication.
- Further validation is needed to confirm its potential in reducing PTB risk and rates, especially when integrated with treatment data.
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