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Predicting Risk of Spontaneous Preterm Delivery in Women with a Singleton Pregnancy

Morken, Nils-Halvdan; Källén, Karin LU and Jacobsson, Bo (2014) In Paediatric and Perinatal Epidemiology 28(1). p.11-22
Abstract
BackgroundPrediction of a woman's risk of a spontaneous preterm delivery (PTD) is a core challenge and an unresolved problem in today's obstetric practice. The objective of this study was to develop prediction models for spontaneous PTD (<37 weeks). MethodsA population-based register study of women born in Sweden with spontaneous onset of delivery was designed using Swedish Medical Birth Register data for 1992-2008. Predictive variables were identified by multiple logistic regression analysis, and outputs were used to calculate adjusted likelihood ratios in primiparous (n=199272) and multiparous (n=249580) singleton pregnant women. The predictive ability of each model was validated in a separate test sample for primiparous (n=190936)... (More)
BackgroundPrediction of a woman's risk of a spontaneous preterm delivery (PTD) is a core challenge and an unresolved problem in today's obstetric practice. The objective of this study was to develop prediction models for spontaneous PTD (<37 weeks). MethodsA population-based register study of women born in Sweden with spontaneous onset of delivery was designed using Swedish Medical Birth Register data for 1992-2008. Predictive variables were identified by multiple logistic regression analysis, and outputs were used to calculate adjusted likelihood ratios in primiparous (n=199272) and multiparous (n=249580) singleton pregnant women. The predictive ability of each model was validated in a separate test sample for primiparous (n=190936) and multiparous (n=239203) women, respectively. ResultsFor multiparous women, the area under the ROC curve (AUC) of 0.74 [95% confidence interval (CI) 0.73, 0.74] indicated a satisfying performance of the model, while for primiparous women, it was rather poor {AUC: 0.58 [95% CI 0.57, 0.58]}. For both primiparous and multiparous women, the prediction models were quite good for pregnancies with comparatively low risk for spontaneous PTD, whereas more limited to predict pregnancies with 30% risk of spontaneous PTD. ConclusionsSpontaneous PTD is difficult to predict in multiparous women and nearly impossible in primiparous, by using this statistical method in a large and unselected sample. However, adding clinical data (like cervical length) may in the future further improve its predictive performance. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
predicting risk, spontaneous preterm delivery, singleton pregnancy
in
Paediatric and Perinatal Epidemiology
volume
28
issue
1
pages
11 - 22
publisher
Wiley-Blackwell
external identifiers
  • wos:000327899300003
  • scopus:84890123859
ISSN
0269-5022
DOI
10.1111/ppe.12087
language
English
LU publication?
yes
id
f66954d3-23b9-4e7b-b338-008d42e0b483 (old id 4255902)
date added to LUP
2014-02-10 12:13:27
date last changed
2017-11-05 03:16:58
@article{f66954d3-23b9-4e7b-b338-008d42e0b483,
  abstract     = {BackgroundPrediction of a woman's risk of a spontaneous preterm delivery (PTD) is a core challenge and an unresolved problem in today's obstetric practice. The objective of this study was to develop prediction models for spontaneous PTD (&lt;37 weeks). MethodsA population-based register study of women born in Sweden with spontaneous onset of delivery was designed using Swedish Medical Birth Register data for 1992-2008. Predictive variables were identified by multiple logistic regression analysis, and outputs were used to calculate adjusted likelihood ratios in primiparous (n=199272) and multiparous (n=249580) singleton pregnant women. The predictive ability of each model was validated in a separate test sample for primiparous (n=190936) and multiparous (n=239203) women, respectively. ResultsFor multiparous women, the area under the ROC curve (AUC) of 0.74 [95% confidence interval (CI) 0.73, 0.74] indicated a satisfying performance of the model, while for primiparous women, it was rather poor {AUC: 0.58 [95% CI 0.57, 0.58]}. For both primiparous and multiparous women, the prediction models were quite good for pregnancies with comparatively low risk for spontaneous PTD, whereas more limited to predict pregnancies with 30% risk of spontaneous PTD. ConclusionsSpontaneous PTD is difficult to predict in multiparous women and nearly impossible in primiparous, by using this statistical method in a large and unselected sample. However, adding clinical data (like cervical length) may in the future further improve its predictive performance.},
  author       = {Morken, Nils-Halvdan and Källén, Karin and Jacobsson, Bo},
  issn         = {0269-5022},
  keyword      = {predicting risk,spontaneous preterm delivery,singleton pregnancy},
  language     = {eng},
  number       = {1},
  pages        = {11--22},
  publisher    = {Wiley-Blackwell},
  series       = {Paediatric and Perinatal Epidemiology},
  title        = {Predicting Risk of Spontaneous Preterm Delivery in Women with a Singleton Pregnancy},
  url          = {http://dx.doi.org/10.1111/ppe.12087},
  volume       = {28},
  year         = {2014},
}