A prospective masked observational study of uterine contraction frequency in twins
This study was undertaken to compare uterine contraction frequency in twins versus singletons and to determine if contraction frequency can be an efficient predictor of spontaneous preterm birth in twin gestations. Fifty-nine twin and 306 singleton gestations were enrolled between 22 and 24 weeks at...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2006-12, Vol.195 (6), p.1564-1570 |
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| creator | Newman, Roger B. Iams, Jay D. Das, Anita Goldenberg, Robert L. Meis, Paul Moawad, Atef Sibai, Baha M. Caritis, Steve N. Miodovnik, Menachem Paul, Richard H. Dombrowski, Mitchell P. Fischer, Molly |
| description | This study was undertaken to compare uterine contraction frequency in twins versus singletons and to determine if contraction frequency can be an efficient predictor of spontaneous preterm birth in twin gestations.
Fifty-nine twin and 306 singleton gestations were enrolled between 22 and 24 weeks at 11 centers. Contraction frequency was recorded with a home uterine activity monitor (HUAM) 2 or more times per day on 2 or more days per week until delivery or 36-6/7 weeks. Masked HUAM data were interpreted according to standard protocol. Repeated measures analyses were used to determine whether mean or maximum uterine contraction frequency per hour differed between singleton and twin gestations across gestational age, by time of day, and by delivery before 35 weeks or beyond. Uterine contraction frequency was also evaluated by logistic regression and receiver operator characteristic (ROC) curves as tests to predict spontaneous preterm birth.
There were 34,908 hours of HUAM data recorded by the 306 singleton gestations and 5,427 hours by the 59 women with twins. Uterine contraction frequency was significantly greater in twins (
P = .002) compared with singletons, regardless of gestational age. Contraction frequency in twins increased significantly with gestational age and time of day (1600-0359 hours); but was not associated with spontaneous preterm birth. Maximum uterine contraction frequency was associated with preterm birth less than 35 weeks but only in the morning (
am) recording (0400-1559) and at the 29- to 30-week gestational age interval. This relationship was modest (odds ratio 1-2) and not consistent across gestational age or between the
am and afternoon/evening (
pm) monitoring sessions. ROC analysis revealed no contraction frequency that efficiently identified twins who delivered prematurely at any 2-week gestational age interval.
Mean uterine contraction frequency was significantly higher for twin gestations than singletons throughout the latter half of pregnancy and between 1600 and 0359 hours but was not higher among twins who delivered less than 35 weeks' gestation. Neither maximum
am or
pm contraction frequency predicted spontaneous preterm birth less than 35 weeks' gestation in twin pregnancies. |
| doi_str_mv | 10.1016/j.ajog.2006.03.063 |
| format | Article |
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Fifty-nine twin and 306 singleton gestations were enrolled between 22 and 24 weeks at 11 centers. Contraction frequency was recorded with a home uterine activity monitor (HUAM) 2 or more times per day on 2 or more days per week until delivery or 36-6/7 weeks. Masked HUAM data were interpreted according to standard protocol. Repeated measures analyses were used to determine whether mean or maximum uterine contraction frequency per hour differed between singleton and twin gestations across gestational age, by time of day, and by delivery before 35 weeks or beyond. Uterine contraction frequency was also evaluated by logistic regression and receiver operator characteristic (ROC) curves as tests to predict spontaneous preterm birth.
There were 34,908 hours of HUAM data recorded by the 306 singleton gestations and 5,427 hours by the 59 women with twins. Uterine contraction frequency was significantly greater in twins (
P = .002) compared with singletons, regardless of gestational age. Contraction frequency in twins increased significantly with gestational age and time of day (1600-0359 hours); but was not associated with spontaneous preterm birth. Maximum uterine contraction frequency was associated with preterm birth less than 35 weeks but only in the morning (
am) recording (0400-1559) and at the 29- to 30-week gestational age interval. This relationship was modest (odds ratio 1-2) and not consistent across gestational age or between the
am and afternoon/evening (
pm) monitoring sessions. ROC analysis revealed no contraction frequency that efficiently identified twins who delivered prematurely at any 2-week gestational age interval.
Mean uterine contraction frequency was significantly higher for twin gestations than singletons throughout the latter half of pregnancy and between 1600 and 0359 hours but was not higher among twins who delivered less than 35 weeks' gestation. Neither maximum
am or
pm contraction frequency predicted spontaneous preterm birth less than 35 weeks' gestation in twin pregnancies.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2006.03.063</identifier><identifier>PMID: 16769014</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adult ; Biological and medical sciences ; Contraction frequency ; Female ; Gestational Age ; Gynecology. Andrology. Obstetrics ; Humans ; Medical sciences ; Predictive Value of Tests ; Pregnancy ; Pregnancy, Multiple - physiology ; Premature Birth ; Preterm birth ; Prospective Studies ; ROC Curve ; Single-Blind Method ; Twin gestations ; Twins ; Uterine Contraction ; Uterine Monitoring</subject><ispartof>American journal of obstetrics and gynecology, 2006-12, Vol.195 (6), p.1564-1570</ispartof><rights>2006 Mosby, Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-f9ae106ae9e14b73ded10bb5b77ff0716623721be7b74dcce54a439e9f0157963</citedby><cites>FETCH-LOGICAL-c384t-f9ae106ae9e14b73ded10bb5b77ff0716623721be7b74dcce54a439e9f0157963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajog.2006.03.063$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18453834$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16769014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Newman, Roger B.</creatorcontrib><creatorcontrib>Iams, Jay D.</creatorcontrib><creatorcontrib>Das, Anita</creatorcontrib><creatorcontrib>Goldenberg, Robert L.</creatorcontrib><creatorcontrib>Meis, Paul</creatorcontrib><creatorcontrib>Moawad, Atef</creatorcontrib><creatorcontrib>Sibai, Baha M.</creatorcontrib><creatorcontrib>Caritis, Steve N.</creatorcontrib><creatorcontrib>Miodovnik, Menachem</creatorcontrib><creatorcontrib>Paul, Richard H.</creatorcontrib><creatorcontrib>Dombrowski, Mitchell P.</creatorcontrib><creatorcontrib>Fischer, Molly</creatorcontrib><creatorcontrib>for the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units</creatorcontrib><creatorcontrib>National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units</creatorcontrib><title>A prospective masked observational study of uterine contraction frequency in twins</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>This study was undertaken to compare uterine contraction frequency in twins versus singletons and to determine if contraction frequency can be an efficient predictor of spontaneous preterm birth in twin gestations.
Fifty-nine twin and 306 singleton gestations were enrolled between 22 and 24 weeks at 11 centers. Contraction frequency was recorded with a home uterine activity monitor (HUAM) 2 or more times per day on 2 or more days per week until delivery or 36-6/7 weeks. Masked HUAM data were interpreted according to standard protocol. Repeated measures analyses were used to determine whether mean or maximum uterine contraction frequency per hour differed between singleton and twin gestations across gestational age, by time of day, and by delivery before 35 weeks or beyond. Uterine contraction frequency was also evaluated by logistic regression and receiver operator characteristic (ROC) curves as tests to predict spontaneous preterm birth.
There were 34,908 hours of HUAM data recorded by the 306 singleton gestations and 5,427 hours by the 59 women with twins. Uterine contraction frequency was significantly greater in twins (
P = .002) compared with singletons, regardless of gestational age. Contraction frequency in twins increased significantly with gestational age and time of day (1600-0359 hours); but was not associated with spontaneous preterm birth. Maximum uterine contraction frequency was associated with preterm birth less than 35 weeks but only in the morning (
am) recording (0400-1559) and at the 29- to 30-week gestational age interval. This relationship was modest (odds ratio 1-2) and not consistent across gestational age or between the
am and afternoon/evening (
pm) monitoring sessions. ROC analysis revealed no contraction frequency that efficiently identified twins who delivered prematurely at any 2-week gestational age interval.
Mean uterine contraction frequency was significantly higher for twin gestations than singletons throughout the latter half of pregnancy and between 1600 and 0359 hours but was not higher among twins who delivered less than 35 weeks' gestation. Neither maximum
am or
pm contraction frequency predicted spontaneous preterm birth less than 35 weeks' gestation in twin pregnancies.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Contraction frequency</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy, Multiple - physiology</subject><subject>Premature Birth</subject><subject>Preterm birth</subject><subject>Prospective Studies</subject><subject>ROC Curve</subject><subject>Single-Blind Method</subject><subject>Twin gestations</subject><subject>Twins</subject><subject>Uterine Contraction</subject><subject>Uterine Monitoring</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMoun78AQ-Si95aJ003acCLiF8gCKLnkKYTydpt16Rd2X9vyi548zQM88ww70PIOYOcARPXi9ws-s-8ABA58BwE3yMzBkpmohLVPpkBQJEpLqsjchzjYmoLVRySIyakUMDKGXm7pavQxxXawa-RLk38wob2dcSwNoPvO9PSOIzNhvaOjgMG3yG1fTcEY6cxdQG_R-zshvqODj--i6fkwJk24tmunpCPh_v3u6fs5fXx-e72JbO8KofMKYMMhEGFrKwlb7BhUNfzWkrnQDIhCi4LVqOsZdlYi_PSlFyhcsDmUgl-Qq62d1OA9EIc9NJHi21rOuzHqEXFVMFAJrDYgjYljQGdXgW_NGGjGejJpF7oyaSeTGrgOplMSxe762O9xOZvZacuAZc7wERrWhdMZ33846pyzis-cTdbDpOLtcego_VJGDY-JOu66f1_f_wCO7WS2w</recordid><startdate>20061201</startdate><enddate>20061201</enddate><creator>Newman, Roger B.</creator><creator>Iams, Jay D.</creator><creator>Das, Anita</creator><creator>Goldenberg, Robert L.</creator><creator>Meis, Paul</creator><creator>Moawad, Atef</creator><creator>Sibai, Baha M.</creator><creator>Caritis, Steve N.</creator><creator>Miodovnik, Menachem</creator><creator>Paul, Richard H.</creator><creator>Dombrowski, Mitchell P.</creator><creator>Fischer, Molly</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>20061201</creationdate><title>A prospective masked observational study of uterine contraction frequency in twins</title><author>Newman, Roger B. ; Iams, Jay D. ; Das, Anita ; Goldenberg, Robert L. ; Meis, Paul ; Moawad, Atef ; Sibai, Baha M. ; Caritis, Steve N. ; Miodovnik, Menachem ; Paul, Richard H. ; Dombrowski, Mitchell P. ; Fischer, Molly</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-f9ae106ae9e14b73ded10bb5b77ff0716623721be7b74dcce54a439e9f0157963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Contraction frequency</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy, Multiple - physiology</topic><topic>Premature Birth</topic><topic>Preterm birth</topic><topic>Prospective Studies</topic><topic>ROC Curve</topic><topic>Single-Blind Method</topic><topic>Twin gestations</topic><topic>Twins</topic><topic>Uterine Contraction</topic><topic>Uterine Monitoring</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Newman, Roger B.</creatorcontrib><creatorcontrib>Iams, Jay D.</creatorcontrib><creatorcontrib>Das, Anita</creatorcontrib><creatorcontrib>Goldenberg, Robert L.</creatorcontrib><creatorcontrib>Meis, Paul</creatorcontrib><creatorcontrib>Moawad, Atef</creatorcontrib><creatorcontrib>Sibai, Baha M.</creatorcontrib><creatorcontrib>Caritis, Steve N.</creatorcontrib><creatorcontrib>Miodovnik, Menachem</creatorcontrib><creatorcontrib>Paul, Richard H.</creatorcontrib><creatorcontrib>Dombrowski, Mitchell P.</creatorcontrib><creatorcontrib>Fischer, Molly</creatorcontrib><creatorcontrib>for the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units</creatorcontrib><creatorcontrib>National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units</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>Newman, Roger B.</au><au>Iams, Jay D.</au><au>Das, Anita</au><au>Goldenberg, Robert L.</au><au>Meis, Paul</au><au>Moawad, Atef</au><au>Sibai, Baha M.</au><au>Caritis, Steve N.</au><au>Miodovnik, Menachem</au><au>Paul, Richard H.</au><au>Dombrowski, Mitchell P.</au><au>Fischer, Molly</au><aucorp>for the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units</aucorp><aucorp>National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective masked observational study of uterine contraction frequency in twins</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>195</volume><issue>6</issue><spage>1564</spage><epage>1570</epage><pages>1564-1570</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>This study was undertaken to compare uterine contraction frequency in twins versus singletons and to determine if contraction frequency can be an efficient predictor of spontaneous preterm birth in twin gestations.
Fifty-nine twin and 306 singleton gestations were enrolled between 22 and 24 weeks at 11 centers. Contraction frequency was recorded with a home uterine activity monitor (HUAM) 2 or more times per day on 2 or more days per week until delivery or 36-6/7 weeks. Masked HUAM data were interpreted according to standard protocol. Repeated measures analyses were used to determine whether mean or maximum uterine contraction frequency per hour differed between singleton and twin gestations across gestational age, by time of day, and by delivery before 35 weeks or beyond. Uterine contraction frequency was also evaluated by logistic regression and receiver operator characteristic (ROC) curves as tests to predict spontaneous preterm birth.
There were 34,908 hours of HUAM data recorded by the 306 singleton gestations and 5,427 hours by the 59 women with twins. Uterine contraction frequency was significantly greater in twins (
P = .002) compared with singletons, regardless of gestational age. Contraction frequency in twins increased significantly with gestational age and time of day (1600-0359 hours); but was not associated with spontaneous preterm birth. Maximum uterine contraction frequency was associated with preterm birth less than 35 weeks but only in the morning (
am) recording (0400-1559) and at the 29- to 30-week gestational age interval. This relationship was modest (odds ratio 1-2) and not consistent across gestational age or between the
am and afternoon/evening (
pm) monitoring sessions. ROC analysis revealed no contraction frequency that efficiently identified twins who delivered prematurely at any 2-week gestational age interval.
Mean uterine contraction frequency was significantly higher for twin gestations than singletons throughout the latter half of pregnancy and between 1600 and 0359 hours but was not higher among twins who delivered less than 35 weeks' gestation. Neither maximum
am or
pm contraction frequency predicted spontaneous preterm birth less than 35 weeks' gestation in twin pregnancies.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>16769014</pmid><doi>10.1016/j.ajog.2006.03.063</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9378 |
| ispartof | American journal of obstetrics and gynecology, 2006-12, Vol.195 (6), p.1564-1570 |
| issn | 0002-9378 1097-6868 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Biological and medical sciences Contraction frequency Female Gestational Age Gynecology. Andrology. Obstetrics Humans Medical sciences Predictive Value of Tests Pregnancy Pregnancy, Multiple - physiology Premature Birth Preterm birth Prospective Studies ROC Curve Single-Blind Method Twin gestations Twins Uterine Contraction Uterine Monitoring |
| title | A prospective masked observational study of uterine contraction frequency in twins |
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