- Premature effacement of the cervix, or short cervix, in the midtrimester of pregnancy currently represents the strongest predictor of spontaneous preterm birth.
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Premature effacement of the cervix, or short cervix, in the midtrimester of pregnancy currently represents the strongest predictor of spontaneous preterm birth. Numerous studies have examined the relationship between short cervix and preterm birth, and although differences in sensitivity and predictive value exist, the overwhelming consensus indicates that the risk of preterm birth increases with decreasing cervical length.
- Joan Slager, Sandra Lynne
Nov 11, 2020 · Although previous preterm birth is a risk factor for recurrent preterm birth, most spontaneous preterm births occur in women with no previous history of preterm birth. Family history is a predictor of current preterm birth - American Journal of Obstetrics & Gynecology MFM
- Amanda Koire, Derrick M. Chu, Kjersti Aagaard
- Clinical Context
- Study Synopsis and Perspective
- Clinical Implications
Spontaneous preterm birth (SPTB) is one of the most common complications of pregnancy, affecting 11% to 12% of births in the United States. The authors of the current study note that, other than a history of cervical surgery, there are few established risk factors for preterm birth among nulliparous women with a singleton pregnancy. Maternal history alone fails to account for more than half of women at risk for preterm birth. The presence of vaginal fetal fibronectin can indicate a higher risk for preterm birth, but positive test results are meaningful only after 22 weeks' gestation and may not be evident until only shortly before preterm labor. Therefore, the goal of the current study by Dekker and colleagues was to evaluate risk factors for preterm birth, particularly among nulliparous women.
Clinical characteristics are a poor predictor of SPTB in nulliparous women, according to the results of a new study. In addition, the trial suggests, the risk factors for SPTB with intact membranes (SPTB-IM) differ from the risk factors for SPTB after prelabor rupture of the membranes (SPTB-PPROM). This suggests that there are different pathophysiological pathways underlying these distinct phenotypes. Gustaaf Albert Dekker, MD, PhD, from the University of Adelaide's Robinson Institute in South Australia, and colleagues published the results of a multicenter international study in the July issue of PLoS ONE. The study included a prospective cohort of low-risk nulliparous pregnant women. Of the 3234 women included in the study, the researchers documented 156 cases of SPTB. Smoking was more common in the SPTB-IM group (22.9% vs 10.6% in term births; P< .001). "Not feeling well" was also a risk factor for SPTB-IM, as was marijuana use before pregnancy. The presence of mild hypertension...SPTB affects 11% to 12% of deliveries in the United States. Maternal history alone fails to account for more than half of women at risk for preterm birth. The presence of vaginal fetal fibronectin...The current study by Dekker and colleagues demonstrates that clinical data are only modestly useful in predicting the risk for preterm birth in nulliparous women. Only shortened cervical length was...
Women who conceive through ART are at higher risk for preterm birth, primarily because they are more likely to be pregnant with more than one baby at a time. More detailed information on ART and preterm birth can be found in the CDC’s 2016 Assisted Reproductive Technology Report pdf icon [PDF – 5MB] .
The strongest predictor of preterm birth was having a history of preterm birth in a prior pregnancy (OR, 2.55; 95% CI, 1.54-4.24; P < .001). DISCUSSION: Prenatal perceived stress levels may be a risk factor for preterm birth independent of preterm labor; however, prenatal stress was not associated with preterm labor.
- Laura Seravalli, Freda Patterson, Deborah B. Nelson