Predictive Factors for Delivery within 7 Days after Successful 48-Hour Treatment of Threatened Preterm Labor

Carolien Roos; Ewoud Schuit; Hubertina C. J. Scheepers; Kitty W. M. Bloemenkamp; Antoinette C. Bolte; Hans J. J. Duvekot; Jim van Eyck; Joke H. Kok; Anneke Kwee; Ashley E. R. Merién; Brent C. Opmeer; Martijn A. Oudijk; Mariëlle G. van Pampus; Dimitri N. M. Papatsonis; Martina M. Porath; Krystyna M. Sollie; Marc E. A. Spaanderman; Sylvia M. C. Vijgen; Christine Willekes; Fred K. Lotgering; Joris A. M. van der Post; Ben Willem J. Mol; for APOSTEL-II Study Group

doi:10.1055/s-0035-1552930

American Journal of Perinatology Reports, Inhaltsverzeichnis

AJP Rep 2015; 05(02): e141-e149
DOI: 10.1055/s-0035-1552930

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Predictive Factors for Delivery within 7 Days after Successful 48-Hour Treatment of Threatened Preterm Labor

Carolien Roos

¹Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands

,

Ewoud Schuit

²Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

,

Hubertina C. J. Scheepers

³Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands

,

Kitty W. M. Bloemenkamp

⁴Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands

,

Antoinette C. Bolte

¹Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands

,

Hans J. J. Duvekot

⁵Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands

,

Jim van Eyck

⁶Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, The Netherlands

,

Joke H. Kok

⁷Department of Neonatology, Academic Medical Center, Amsterdam, The Netherlands

,

Anneke Kwee

⁸Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Ashley E. R. Merién

⁹Department of Obstetrics and Gynecology, Ziekenhuis Rijnstate, Arnhem, The Netherlands

,

Brent C. Opmeer

¹⁰Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands

,

Martijn A. Oudijk

⁸Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Mariëlle G. van Pampus

¹¹Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

,

Dimitri N. M. Papatsonis

¹²Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands

,

Martina M. Porath

¹³Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands

,

Krystyna M. Sollie

¹⁴Department of Obstetrics and Gynecology, University Medical Center, Groningen, The Netherlands

,

Marc E. A. Spaanderman

³Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands

,

Sylvia M. C. Vijgen

¹⁵College voor Zorgverzekeringen, Diemen, The Netherlands

,

Christine Willekes

³Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands

,

Fred K. Lotgering

¹Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands

,

Joris A. M. van der Post

¹⁶Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands

,

Ben Willem J. Mol

¹⁷The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia

,

for APOSTEL-II Study Group

› Institutsangaben

Abstract

Objective The aim of this study was to assess which characteristics and results of vaginal examination are predictive for delivery within 7 days, in women with threatened preterm labor after initial treatment.

Study Design A secondary analysis of a randomized controlled trial on maintenance nifedipine includes women who remained undelivered after threatened preterm labor for 48 hours. We developed one model for women with premature prelabor rupture of membranes (PPROM) and one without PPROM. The predictors were identified by backward selection. We assessed calibration and discrimination and used bootstrapping techniques to correct for potential overfitting.

Results For women with PPROM (model 1), nulliparity, history of preterm birth, and vaginal bleeding were included in the multivariable analysis. For women without PPROM (model 2), maternal age, vaginal bleeding, cervical length, and fetal fibronectin (fFN) status were in the multivariable analysis. Discriminative capability was moderate to good (c-statistic 0.68; 95% confidence interval [CI] 0.60–0.77 for model 1 and 0.89; 95% CI, 0.84–0.93 for model 2).

Conclusion PPROM and vaginal bleeding in the current pregnancy are relevant predictive factors in all women, as are maternal age, cervical length, and fFN in women without PPROM and nulliparity, history of preterm birth in women with PPROM.

Keywords

predictive factors - preterm delivery - maintenance tocolysis

Volltext

Referenzen

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