The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length
Objective The objective of the study was to estimate the predictive value of cervical length (CL) and fetal fibronectin (fFN) in patients being treated with 17-alpha-hydroxyprogesterone caproate (17P). Methods This was a retrospective cohort of 176 patients with a prior spontaneous preterm birth bei...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2012-07, Vol.207 (1), p.51.e1-51.e5 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Romero, Julie, MD Rebarber, Andrei, MD Saltzman, Daniel H., MD Schwartz, Rachel, BS Peress, Danielle, BS Fox, Nathan S., MD |
| description | Objective The objective of the study was to estimate the predictive value of cervical length (CL) and fetal fibronectin (fFN) in patients being treated with 17-alpha-hydroxyprogesterone caproate (17P). Methods This was a retrospective cohort of 176 patients with a prior spontaneous preterm birth being treated with weekly injections of 17P who underwent serial CL and fFN screening. Results A short CL (≤25 mm) was significantly associated with an earlier gestational age at delivery and with recurrent preterm birth at less than 37, less than 35, less than 34, and less than 32 weeks. A positive fFN was not significantly associated with recurrent preterm birth. As a screening test for recurrent preterm birth, the positive and negative likelihood ratios for CL were 2.04 and 0.35, respectively, whereas for fFN they were 1.22 and 0.98, respectively, indicating that fFN did not offer any additional predictive value. Conclusion In patients being treated with 17P, cervical length at 22-32 weeks is predictive of recurrent preterm birth, but fetal fibronectin is not. |
| doi_str_mv | 10.1016/j.ajog.2012.04.024 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1022259970</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0002937812004218</els_id><sourcerecordid>1022259970</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-d04fe158846d6ed81c84d0572930058d9d79d80dd316ff493bfffe8b3207b33d3</originalsourceid><addsrcrecordid>eNp9kl2L1TAQhoso7tnVP-CF5EbwpjUf_UhBhGVxVVjwwvU6pMnkNLUnrUm7eH6G_9gp56jghTcJkzwzmbzvZNkLRgtGWf1mKPQw7QtOGS9oWVBePsp2jLZNXstaPs52lFKet6KRF9llSsMW8pY_zS44r9oKz3fZz_seyBzBerP4KZDJkQhmjRHCsp0vEA-k83HpiQ9k1ovHi0SQZE2ux7nXeX-0cfpxnOO0h4T8FIAYjaFegKzJhz1JEL0eiYNlW323MfheIDpYYiA-eIMXI4T90j_Lnjg9Jnh-3q-yr7fv728-5nefP3y6ub7LTVmyJbe0dMAqKcva1mAlM7K0tGp4KyitpG1t01pJrRWsdq5sReecA9kJTptOCCuustenutjp9xU7VwefDIyjDjCtSTEUC2VqG4ooP6EmTilFcGqO_qDjESG1WaEGtVmhNisULRVagUkvz_XX7gD2T8pv7RF4dQZ0wu-7qIPx6S9XM9EIypB7e-IA1XjwEFUy6IJBz9CqRdnJ_7-Pd_-km9GHTfBvcIQ0TGsMqLNiKmGO-rJNyTYzjFNacibFL-HbvvY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1022259970</pqid></control><display><type>article</type><title>The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Romero, Julie, MD ; Rebarber, Andrei, MD ; Saltzman, Daniel H., MD ; Schwartz, Rachel, BS ; Peress, Danielle, BS ; Fox, Nathan S., MD</creator><creatorcontrib>Romero, Julie, MD ; Rebarber, Andrei, MD ; Saltzman, Daniel H., MD ; Schwartz, Rachel, BS ; Peress, Danielle, BS ; Fox, Nathan S., MD</creatorcontrib><description>Objective The objective of the study was to estimate the predictive value of cervical length (CL) and fetal fibronectin (fFN) in patients being treated with 17-alpha-hydroxyprogesterone caproate (17P). Methods This was a retrospective cohort of 176 patients with a prior spontaneous preterm birth being treated with weekly injections of 17P who underwent serial CL and fFN screening. Results A short CL (≤25 mm) was significantly associated with an earlier gestational age at delivery and with recurrent preterm birth at less than 37, less than 35, less than 34, and less than 32 weeks. A positive fFN was not significantly associated with recurrent preterm birth. As a screening test for recurrent preterm birth, the positive and negative likelihood ratios for CL were 2.04 and 0.35, respectively, whereas for fFN they were 1.22 and 0.98, respectively, indicating that fFN did not offer any additional predictive value. Conclusion In patients being treated with 17P, cervical length at 22-32 weeks is predictive of recurrent preterm birth, but fetal fibronectin is not.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2012.04.024</identifier><identifier>PMID: 22595378</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Biological and medical sciences ; Biomarkers - metabolism ; cervical length ; Cervical Length Measurement ; Cohort Studies ; Decision Support Techniques ; Diseases of mother, fetus and pregnancy ; Female ; fetal fibronectin ; Fibronectins - metabolism ; Gynecology. Andrology. Obstetrics ; Humans ; Hydroxyprogesterones - therapeutic use ; Medical sciences ; Obstetrics and Gynecology ; Pregnancy ; Pregnancy. Fetus. Placenta ; Premature Birth - diagnosis ; Premature Birth - prevention & control ; preterm birth ; progesterone ; Progestins - therapeutic use ; Recurrence ; Regression Analysis ; Retrospective Studies ; Sensitivity and Specificity</subject><ispartof>American journal of obstetrics and gynecology, 2012-07, Vol.207 (1), p.51.e1-51.e5</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-d04fe158846d6ed81c84d0572930058d9d79d80dd316ff493bfffe8b3207b33d3</citedby><cites>FETCH-LOGICAL-c441t-d04fe158846d6ed81c84d0572930058d9d79d80dd316ff493bfffe8b3207b33d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937812004218$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26137301$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22595378$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romero, Julie, MD</creatorcontrib><creatorcontrib>Rebarber, Andrei, MD</creatorcontrib><creatorcontrib>Saltzman, Daniel H., MD</creatorcontrib><creatorcontrib>Schwartz, Rachel, BS</creatorcontrib><creatorcontrib>Peress, Danielle, BS</creatorcontrib><creatorcontrib>Fox, Nathan S., MD</creatorcontrib><title>The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective The objective of the study was to estimate the predictive value of cervical length (CL) and fetal fibronectin (fFN) in patients being treated with 17-alpha-hydroxyprogesterone caproate (17P). Methods This was a retrospective cohort of 176 patients with a prior spontaneous preterm birth being treated with weekly injections of 17P who underwent serial CL and fFN screening. Results A short CL (≤25 mm) was significantly associated with an earlier gestational age at delivery and with recurrent preterm birth at less than 37, less than 35, less than 34, and less than 32 weeks. A positive fFN was not significantly associated with recurrent preterm birth. As a screening test for recurrent preterm birth, the positive and negative likelihood ratios for CL were 2.04 and 0.35, respectively, whereas for fFN they were 1.22 and 0.98, respectively, indicating that fFN did not offer any additional predictive value. Conclusion In patients being treated with 17P, cervical length at 22-32 weeks is predictive of recurrent preterm birth, but fetal fibronectin is not.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>cervical length</subject><subject>Cervical Length Measurement</subject><subject>Cohort Studies</subject><subject>Decision Support Techniques</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Female</subject><subject>fetal fibronectin</subject><subject>Fibronectins - metabolism</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hydroxyprogesterones - therapeutic use</subject><subject>Medical sciences</subject><subject>Obstetrics and Gynecology</subject><subject>Pregnancy</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Premature Birth - diagnosis</subject><subject>Premature Birth - prevention & control</subject><subject>preterm birth</subject><subject>progesterone</subject><subject>Progestins - therapeutic use</subject><subject>Recurrence</subject><subject>Regression Analysis</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1TAQhoso7tnVP-CF5EbwpjUf_UhBhGVxVVjwwvU6pMnkNLUnrUm7eH6G_9gp56jghTcJkzwzmbzvZNkLRgtGWf1mKPQw7QtOGS9oWVBePsp2jLZNXstaPs52lFKet6KRF9llSsMW8pY_zS44r9oKz3fZz_seyBzBerP4KZDJkQhmjRHCsp0vEA-k83HpiQ9k1ovHi0SQZE2ux7nXeX-0cfpxnOO0h4T8FIAYjaFegKzJhz1JEL0eiYNlW323MfheIDpYYiA-eIMXI4T90j_Lnjg9Jnh-3q-yr7fv728-5nefP3y6ub7LTVmyJbe0dMAqKcva1mAlM7K0tGp4KyitpG1t01pJrRWsdq5sReecA9kJTptOCCuustenutjp9xU7VwefDIyjDjCtSTEUC2VqG4ooP6EmTilFcGqO_qDjESG1WaEGtVmhNisULRVagUkvz_XX7gD2T8pv7RF4dQZ0wu-7qIPx6S9XM9EIypB7e-IA1XjwEFUy6IJBz9CqRdnJ_7-Pd_-km9GHTfBvcIQ0TGsMqLNiKmGO-rJNyTYzjFNacibFL-HbvvY</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Romero, Julie, MD</creator><creator>Rebarber, Andrei, MD</creator><creator>Saltzman, Daniel H., MD</creator><creator>Schwartz, Rachel, BS</creator><creator>Peress, Danielle, BS</creator><creator>Fox, Nathan S., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length</title><author>Romero, Julie, MD ; Rebarber, Andrei, MD ; Saltzman, Daniel H., MD ; Schwartz, Rachel, BS ; Peress, Danielle, BS ; Fox, Nathan S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-d04fe158846d6ed81c84d0572930058d9d79d80dd316ff493bfffe8b3207b33d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - metabolism</topic><topic>cervical length</topic><topic>Cervical Length Measurement</topic><topic>Cohort Studies</topic><topic>Decision Support Techniques</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Female</topic><topic>fetal fibronectin</topic><topic>Fibronectins - metabolism</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hydroxyprogesterones - therapeutic use</topic><topic>Medical sciences</topic><topic>Obstetrics and Gynecology</topic><topic>Pregnancy</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Premature Birth - diagnosis</topic><topic>Premature Birth - prevention & control</topic><topic>preterm birth</topic><topic>progesterone</topic><topic>Progestins - therapeutic use</topic><topic>Recurrence</topic><topic>Regression Analysis</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Romero, Julie, MD</creatorcontrib><creatorcontrib>Rebarber, Andrei, MD</creatorcontrib><creatorcontrib>Saltzman, Daniel H., MD</creatorcontrib><creatorcontrib>Schwartz, Rachel, BS</creatorcontrib><creatorcontrib>Peress, Danielle, BS</creatorcontrib><creatorcontrib>Fox, Nathan S., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romero, Julie, MD</au><au>Rebarber, Andrei, MD</au><au>Saltzman, Daniel H., MD</au><au>Schwartz, Rachel, BS</au><au>Peress, Danielle, BS</au><au>Fox, Nathan S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>207</volume><issue>1</issue><spage>51.e1</spage><epage>51.e5</epage><pages>51.e1-51.e5</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective The objective of the study was to estimate the predictive value of cervical length (CL) and fetal fibronectin (fFN) in patients being treated with 17-alpha-hydroxyprogesterone caproate (17P). Methods This was a retrospective cohort of 176 patients with a prior spontaneous preterm birth being treated with weekly injections of 17P who underwent serial CL and fFN screening. Results A short CL (≤25 mm) was significantly associated with an earlier gestational age at delivery and with recurrent preterm birth at less than 37, less than 35, less than 34, and less than 32 weeks. A positive fFN was not significantly associated with recurrent preterm birth. As a screening test for recurrent preterm birth, the positive and negative likelihood ratios for CL were 2.04 and 0.35, respectively, whereas for fFN they were 1.22 and 0.98, respectively, indicating that fFN did not offer any additional predictive value. Conclusion In patients being treated with 17P, cervical length at 22-32 weeks is predictive of recurrent preterm birth, but fetal fibronectin is not.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22595378</pmid><doi>10.1016/j.ajog.2012.04.024</doi><tpages>2</tpages></addata></record> |
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| ispartof | American journal of obstetrics and gynecology, 2012-07, Vol.207 (1), p.51.e1-51.e5 |
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| subjects | Adult Biological and medical sciences Biomarkers - metabolism cervical length Cervical Length Measurement Cohort Studies Decision Support Techniques Diseases of mother, fetus and pregnancy Female fetal fibronectin Fibronectins - metabolism Gynecology. Andrology. Obstetrics Humans Hydroxyprogesterones - therapeutic use Medical sciences Obstetrics and Gynecology Pregnancy Pregnancy. Fetus. Placenta Premature Birth - diagnosis Premature Birth - prevention & control preterm birth progesterone Progestins - therapeutic use Recurrence Regression Analysis Retrospective Studies Sensitivity and Specificity |
| title | The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length |
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