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Related Experiment Videos

The preterm prediction study: a clinical risk assessment system

B M Mercer1, R L Goldenberg, A Das

  • 1National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, Maryland, USA.

American Journal of Obstetrics and Gynecology
|June 1, 1996
PubMed
Summary

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A risk assessment system was developed to predict spontaneous preterm delivery using clinical data at 23-24 weeks gestation. While associated with increased risk, the system identified only a minority of women who delivered preterm.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Reproductive Health

Background:

  • Spontaneous preterm delivery (SPD) remains a significant challenge in perinatal care.
  • Early identification of at-risk pregnancies is crucial for timely intervention.
  • Existing predictive models often lack sufficient accuracy or applicability.

Purpose of the Study:

  • To develop and validate a risk assessment system for predicting spontaneous preterm delivery.
  • To utilize clinical information available at 23 to 24 weeks' gestation.
  • To determine the predictive value of the developed risk assessment system.

Main Methods:

  • A cohort of 2929 women was evaluated at 23-24 weeks' gestation.
  • Demographic, socioeconomic, environmental, medical, and pregnancy-specific factors were assessed.

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  • Multivariate logistic regression was used to develop the risk model, validated on a separate 15% of the cohort.

    • Main Results:

    • The risk assessment system showed significant associations with SPD (p < 0.0001).
    • Factors like low BMI, high Bishop scores, race, social environment, and prior obstetric history were significant predictors.
    • High-risk women identified by the system had a 3.3- to 3.8-fold increased risk of SPD, but sensitivities were low (18.2%-24.2%).

    Conclusions:

    • A risk assessment system incorporating various factors can identify women at higher risk for SPD.
    • However, the current system identifies only a minority of women who ultimately deliver preterm.
    • The system holds investigational value for developing new technologies to identify at-risk subpopulations.