Predicting early delivery in pregnant women

Two prediction models using analysis of amniotic or cervical fluids may help identify which pregnant women in preterm labor will deliver within 7 days, according to research published in the August issue of Obstetrics & Gynecology.

Rose-Marie Holst, MD, of the Sahlgrenska University Hospital East in Goteborg, Sweden, and colleagues analyzed data from 89 women presenting in preterm labor at 22 to 33 weeks of gestational age. Women underwent testing for 27 proteins in amniotic and cervical fluids.

The researchers found that a multivariable prediction model incorporating amniotic macrophage inflammatory protein-1β, cervical interferon-γ, and monocyte chemotactic protein-1 predicted outcome with 91% sensitivity, 84% specificity, and 78% positive and 94% negative predictive value. Another model, this one noninvasive, incorporated factors including cervical length and cervical interferon-γ, and predicted early delivery with 85% sensitivity, 82% specificity, and 74% positive and 90% negative predictive value.

“We found two different prediction models that might be useful to clinicians in discriminating between women with symptoms who will deliver preterm and women who will not. The reasonably high positive predictive value and negative predictive value means that both women at considerable risk of delivering preterm and who may be targeted for treatment and women at low risk who could be sent home can be identified," the authors write.

Holst RM, Hagberg H, Wennerholm UB, et al. Prediction of spontaneous preterm delivery in women with preterm labor: analysis of multiple proteins in amniotic and cervical fluids.

Obstet Gynecol

. 2009;114:268-277.