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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
1   Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
,
Ewoud Schuit
2   Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
,
Hubertina C. J. Scheepers
3   Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
,
Kitty W. M. Bloemenkamp
4   Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
,
Antoinette C. Bolte
1   Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
,
Hans J. J. Duvekot
5   Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands
,
Jim van Eyck
6   Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, The Netherlands
,
Joke H. Kok
7   Department of Neonatology, Academic Medical Center, Amsterdam, The Netherlands
,
Anneke Kwee
8   Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
,
Ashley E. R. Merién
9   Department of Obstetrics and Gynecology, Ziekenhuis Rijnstate, Arnhem, The Netherlands
,
Brent C. Opmeer
10   Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands
,
Martijn A. Oudijk
8   Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
,
Mariëlle G. van Pampus
11   Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
,
Dimitri N. M. Papatsonis
12   Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands
,
Martina M. Porath
13   Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
,
Krystyna M. Sollie
14   Department of Obstetrics and Gynecology, University Medical Center, Groningen, The Netherlands
,
Marc E. A. Spaanderman
3   Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
,
Sylvia M. C. Vijgen
15   College voor Zorgverzekeringen, Diemen, The Netherlands
,
Christine Willekes
3   Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
,
Fred K. Lotgering
1   Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
,
Joris A. M. van der Post
16   Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands
,
Ben Willem J. Mol
17   The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
,
for APOSTEL-II Study Group › Author Affiliations
Further Information

Publication History

23 November 2014

25 March 2015

Publication Date:
03 June 2015 (online)

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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

Note

The trial was registered in the Dutch Trial Register, NTR 1336, www.trialregister.nl.


 

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