期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 208, 期 6, 页码 -出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2013.03.005
关键词
cholesterol; prediction; preterm birth; serum screening
资金
- Bill and Melinda Gates Millennium [OPP52256, RSDP 5K12 HD-000849-23]
- National Institutes of Health [R01 HD-57192, R01 HD-52953]
- University of Iowa [T325GM007337, 2 UL1 TR000442-06]
- March of Dimes [6-FY11-261, 11-FY10-180]
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.
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