Document Detail

Maternal admission characteristics as risk factors for preterm birth.
MedLine Citation:
PMID:  14687737     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of this study is to identify a subset of women presenting with preterm labor not responding upon tocolytic therapy, eventually resulting in preterm birth. STUDY DESIGN: The maternal admission characteristics of 185 women with preterm labor receiving tocolysis were analysed for risk factors that could predict which women will deliver within 48 h after the start of tocolysis, or before 34 weeks gestation. Univariate analysis and multivariate logistic regression analysis was performed. RESULTS: Logistic regression analysis identified the following risk factors for delivery within 48 h after the start of tocolysis: cervical dilatation at admission (odds ratio (OR, cm(-1)) 1.47; 95% confidence interval (CI), 1.44-1.49), elevated leukocyte count at admission (per 10(3) leukocytes/mm(3)) (OR 1.27; 95% CI, 1.26-1.28), use of nifedipine (OR 0.49; 95% CI, 0.26-0.49), and developing signs suggestive of chorioamnionitis following admission (OR 2.12; 95% CI, 1.04-4.33). For delivery before 34 weeks of gestation the following risk factors were identified: use of steroids (OR 5.87; 95% CI, 2.34-14.7), use of nifedipine (OR 0.46; 95% CI, 0.27-0.85), developing signs suggestive of chorioamnionitis following admission (OR 10.6; 95% CI, 3.1-35.9), and preterm premature rupture of the membranes (OR 12; 95% CI, 4.1-35.2). CONCLUSIONS: Risk factors associated for delivery within 48 h after starting tocolysis are: cervical dilatation at admission, elevated leukocyte count at admission, and developing signs suggestive of chorioamnionitis following admission. Use of nifedipine was associated with a delay of delivery >48 h. Risk factors associated for delivery within 34 weeks gestation are: use of steroids, developing signs suggestive of chorioamnionitis following admission, and ruptured membranes. Use of nifedipine was associated with a delay >34 weeks.
Dimitrios N M Papatsonis; Herman P van Geijn; Otto P Bleker; Herman J Ader; Gustaaf A Dekker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  112     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-22     Completed Date:  2004-02-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  43-8     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
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MeSH Terms
Confidence Intervals
Follow-Up Studies
Gestational Age
Hospitals, University
Infant, Newborn
Infant, Premature
Labor Stage, First / drug effects
Logistic Models
Nifedipine / therapeutic use
Obstetric Labor, Premature / epidemiology*,  prevention & control*
Odds Ratio
Patient Admission
Pregnancy Outcome*
Risk Factors
Ritodrine / therapeutic use
Tocolysis / methods*
Tocolytic Agents / therapeutic use*
Reg. No./Substance:
0/Tocolytic Agents; 21829-25-4/Nifedipine; 26652-09-5/Ritodrine

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