Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Frederik J R Hermans; Merel M C Bruijn; Jolande Y Vis; Femke F Wilms; Martijn A Oudijk; Martina M Porath; Hubertina C J Scheepers; Kitty W M Bloemenkamp; Caroline J Bax; Jérôme M J Cornette; Bas W A Nij Bijvanck; Maureen T M Franssen; Frank P H A Vandenbussche; Marjolein Kok; William A Grobman; Joris A M Van Der Post; Patrick M M Bossuyt; Brent C Opmeer; Ben Willem J Mol; Ewoud Schuit; Gert-Jan Van Baaren

doi:10.1111/aogs.12643

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Frederik J R Hermans, Merel M C Bruijn, Jolande Y Vis, Femke F Wilms, Martijn A Oudijk, Martina M Porath, Hubertina C J Scheepers, Kitty W M Bloemenkamp, Caroline J Bax, Jérôme M J Cornette, Bas W A Nij Bijvanck, Maureen T M Franssen, Frank P H A Vandenbussche, Marjolein Kok, William A Grobman, Joris A M Van Der Post, Patrick M M Bossuyt, Brent C Opmeer, Ben Willem J Mol, Ewoud SchuitGert-Jan Van Baaren

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To stratify the risk of spontaneous preterm delivery using cervical length (CL) and fetal fibronectin (fFN) in women with threatened preterm labor who remained pregnant after 7 days.

DESIGN: Prospective observational study.

SETTING: Nationwide cohort of women with threatened preterm labor from the Netherlands.

POPULATION: Women with threatened preterm labor between 24 and 34 weeks with a valid CL and fFN measurement and remaining pregnant 7 days after admission.

METHODS: Kaplan-Meier and Cox proportional hazards models were used to estimate cumulative percentages and hazard ratios (HR) for spontaneous delivery.

MAIN OUTCOME MEASURES: Spontaneous delivery between 7 and 14 days after initial presentation and spontaneous preterm delivery before 34 weeks.

RESULTS: The risk of delivery between 7 and 14 days was significantly increased for women with a CL < 15 mm or a CL ≥15 to <30 mm and a positive fFN, compared with women with a CL ≥30 mm: HR 22.3 [95% confidence interval (CI) 2.6-191] and 14 (95% CI 1.8-118), respectively. For spontaneous preterm delivery before 34 weeks the risk was increased for women with a CL < 15 mm [HR 6.3 (95% CI 2.6-15)] or with a CL ≥15 to <30 mm with either positive fFN [HR 3.6 (95% CI 1.5-8.7)] or negative fFN [HR 3.0 (95% CI 1.2-7.1)] compared with women with a CL ≥ 30 mm.

CONCLUSIONS: In women remaining pregnant 7 days after threatened preterm labor, CL and fFN results can be used in risk stratification for spontaneous delivery.

Original language	English
Pages (from-to)	715-721
Number of pages	7
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	94
Issue number	7
DOIs	https://doi.org/10.1111/aogs.12643
Publication status	Published - Jul 2015

Keywords

Adult
Cervical Length Measurement
Female
Fibronectins
Humans
Netherlands
Obstetric Labor, Premature
Pregnancy
Premature Birth
Proportional Hazards Models
Prospective Studies
Risk Assessment
Term Birth

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10.1111/aogs.12643

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Hermans, F. J. R., Bruijn, M. M. C., Vis, J. Y., Wilms, F. F., Oudijk, M. A., Porath, M. M., Scheepers, H. C. J., Bloemenkamp, K. W. M., Bax, C. J., Cornette, J. M. J., Nij Bijvanck, B. W. A., Franssen, M. T. M., Vandenbussche, F. P. H. A., Kok, M., Grobman, W. A., Van Der Post, J. A. M., Bossuyt, P. M. M., Opmeer, B. C., Mol, B. W. J., ... Van Baaren, G.-J. (2015). Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days. Acta Obstetricia et Gynecologica Scandinavica, 94(7), 715-721. https://doi.org/10.1111/aogs.12643

@article{40f6935b772046b1a3eb611dafec18cb,

title = "Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days",

abstract = "OBJECTIVE: To stratify the risk of spontaneous preterm delivery using cervical length (CL) and fetal fibronectin (fFN) in women with threatened preterm labor who remained pregnant after 7 days.DESIGN: Prospective observational study.SETTING: Nationwide cohort of women with threatened preterm labor from the Netherlands.POPULATION: Women with threatened preterm labor between 24 and 34 weeks with a valid CL and fFN measurement and remaining pregnant 7 days after admission.METHODS: Kaplan-Meier and Cox proportional hazards models were used to estimate cumulative percentages and hazard ratios (HR) for spontaneous delivery.MAIN OUTCOME MEASURES: Spontaneous delivery between 7 and 14 days after initial presentation and spontaneous preterm delivery before 34 weeks.RESULTS: The risk of delivery between 7 and 14 days was significantly increased for women with a CL < 15 mm or a CL ≥15 to <30 mm and a positive fFN, compared with women with a CL ≥30 mm: HR 22.3 [95% confidence interval (CI) 2.6-191] and 14 (95% CI 1.8-118), respectively. For spontaneous preterm delivery before 34 weeks the risk was increased for women with a CL < 15 mm [HR 6.3 (95% CI 2.6-15)] or with a CL ≥15 to <30 mm with either positive fFN [HR 3.6 (95% CI 1.5-8.7)] or negative fFN [HR 3.0 (95% CI 1.2-7.1)] compared with women with a CL ≥ 30 mm.CONCLUSIONS: In women remaining pregnant 7 days after threatened preterm labor, CL and fFN results can be used in risk stratification for spontaneous delivery.",

keywords = "Adult, Cervical Length Measurement, Female, Fibronectins, Humans, Netherlands, Obstetric Labor, Premature, Pregnancy, Premature Birth, Proportional Hazards Models, Prospective Studies, Risk Assessment, Term Birth",

author = "Hermans, {Frederik J R} and Bruijn, {Merel M C} and Vis, {Jolande Y} and Wilms, {Femke F} and Oudijk, {Martijn A} and Porath, {Martina M} and Scheepers, {Hubertina C J} and Bloemenkamp, {Kitty W M} and Bax, {Caroline J} and Cornette, {J{\'e}r{\^o}me M J} and {Nij Bijvanck}, {Bas W A} and Franssen, {Maureen T M} and Vandenbussche, {Frank P H A} and Marjolein Kok and Grobman, {William A} and {Van Der Post}, {Joris A M} and Bossuyt, {Patrick M M} and Opmeer, {Brent C} and Mol, {Ben Willem J} and Ewoud Schuit and {Van Baaren}, Gert-Jan",

note = "{\textcopyright} 2015 Nordic Federation of Societies of Obstetrics and Gynecology.",

year = "2015",

month = jul,

doi = "10.1111/aogs.12643",

language = "English",

volume = "94",

pages = "715--721",

journal = "Acta Obstetricia et Gynecologica Scandinavica",

issn = "0001-6349",

publisher = "Wiley-Blackwell",

number = "7",

}

Hermans, FJR, Bruijn, MMC, Vis, JY, Wilms, FF, Oudijk, MA, Porath, MM, Scheepers, HCJ, Bloemenkamp, KWM, Bax, CJ, Cornette, JMJ, Nij Bijvanck, BWA, Franssen, MTM, Vandenbussche, FPHA, Kok, M, Grobman, WA, Van Der Post, JAM, Bossuyt, PMM, Opmeer, BC, Mol, BWJ, Schuit, E & Van Baaren, G-J 2015, 'Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days', Acta Obstetricia et Gynecologica Scandinavica, vol. 94, no. 7, pp. 715-721. https://doi.org/10.1111/aogs.12643

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days. / Hermans, Frederik J R; Bruijn, Merel M C; Vis, Jolande Y et al.
In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 94, No. 7, 07.2015, p. 715-721.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

AU - Hermans, Frederik J R

AU - Bruijn, Merel M C

AU - Vis, Jolande Y

AU - Wilms, Femke F

AU - Oudijk, Martijn A

AU - Porath, Martina M

AU - Scheepers, Hubertina C J

AU - Bloemenkamp, Kitty W M

AU - Bax, Caroline J

AU - Cornette, Jérôme M J

AU - Nij Bijvanck, Bas W A

AU - Franssen, Maureen T M

AU - Vandenbussche, Frank P H A

AU - Kok, Marjolein

AU - Grobman, William A

AU - Van Der Post, Joris A M

AU - Bossuyt, Patrick M M

AU - Opmeer, Brent C

AU - Mol, Ben Willem J

AU - Schuit, Ewoud

AU - Van Baaren, Gert-Jan

PY - 2015/7

Y1 - 2015/7

N2 - OBJECTIVE: To stratify the risk of spontaneous preterm delivery using cervical length (CL) and fetal fibronectin (fFN) in women with threatened preterm labor who remained pregnant after 7 days.DESIGN: Prospective observational study.SETTING: Nationwide cohort of women with threatened preterm labor from the Netherlands.POPULATION: Women with threatened preterm labor between 24 and 34 weeks with a valid CL and fFN measurement and remaining pregnant 7 days after admission.METHODS: Kaplan-Meier and Cox proportional hazards models were used to estimate cumulative percentages and hazard ratios (HR) for spontaneous delivery.MAIN OUTCOME MEASURES: Spontaneous delivery between 7 and 14 days after initial presentation and spontaneous preterm delivery before 34 weeks.RESULTS: The risk of delivery between 7 and 14 days was significantly increased for women with a CL < 15 mm or a CL ≥15 to <30 mm and a positive fFN, compared with women with a CL ≥30 mm: HR 22.3 [95% confidence interval (CI) 2.6-191] and 14 (95% CI 1.8-118), respectively. For spontaneous preterm delivery before 34 weeks the risk was increased for women with a CL < 15 mm [HR 6.3 (95% CI 2.6-15)] or with a CL ≥15 to <30 mm with either positive fFN [HR 3.6 (95% CI 1.5-8.7)] or negative fFN [HR 3.0 (95% CI 1.2-7.1)] compared with women with a CL ≥ 30 mm.CONCLUSIONS: In women remaining pregnant 7 days after threatened preterm labor, CL and fFN results can be used in risk stratification for spontaneous delivery.

AB - OBJECTIVE: To stratify the risk of spontaneous preterm delivery using cervical length (CL) and fetal fibronectin (fFN) in women with threatened preterm labor who remained pregnant after 7 days.DESIGN: Prospective observational study.SETTING: Nationwide cohort of women with threatened preterm labor from the Netherlands.POPULATION: Women with threatened preterm labor between 24 and 34 weeks with a valid CL and fFN measurement and remaining pregnant 7 days after admission.METHODS: Kaplan-Meier and Cox proportional hazards models were used to estimate cumulative percentages and hazard ratios (HR) for spontaneous delivery.MAIN OUTCOME MEASURES: Spontaneous delivery between 7 and 14 days after initial presentation and spontaneous preterm delivery before 34 weeks.RESULTS: The risk of delivery between 7 and 14 days was significantly increased for women with a CL < 15 mm or a CL ≥15 to <30 mm and a positive fFN, compared with women with a CL ≥30 mm: HR 22.3 [95% confidence interval (CI) 2.6-191] and 14 (95% CI 1.8-118), respectively. For spontaneous preterm delivery before 34 weeks the risk was increased for women with a CL < 15 mm [HR 6.3 (95% CI 2.6-15)] or with a CL ≥15 to <30 mm with either positive fFN [HR 3.6 (95% CI 1.5-8.7)] or negative fFN [HR 3.0 (95% CI 1.2-7.1)] compared with women with a CL ≥ 30 mm.CONCLUSIONS: In women remaining pregnant 7 days after threatened preterm labor, CL and fFN results can be used in risk stratification for spontaneous delivery.

KW - Adult

KW - Cervical Length Measurement

KW - Female

KW - Fibronectins

KW - Humans

KW - Netherlands

KW - Obstetric Labor, Premature

KW - Pregnancy

KW - Premature Birth

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Risk Assessment

KW - Term Birth

UR - http://www.scopus.com/inward/record.url?scp=84930418156&partnerID=8YFLogxK

U2 - 10.1111/aogs.12643

DO - 10.1111/aogs.12643

M3 - Article

C2 - 25845495

SN - 0001-6349

VL - 94

SP - 715

EP - 721

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 7

ER -

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

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Keywords

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