Document Detail


Statistical model predicting a short duration to birth in women with preterm labor at 22-35 weeks' gestation: the importance of large vaginal Gram-positive rods.
MedLine Citation:
PMID:  19196208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To identify risk factors for a short interval to birth in women with preterm labor, and to construct a statistical model to predict birth within seven days from the diagnosis of preterm labor at 22-35 weeks of gestation. METHODS: Vaginal flora was obtained from 126 singleton pregnant women hospitalized for preterm labor at 22-35 weeks' gestation. The amount of vaginal large Gram-positive rods (GPR) was counted in a bright field under x400 magnification and classified semiquantitively as loss of GPRs, decreased GPRs (<10), and normal flora (10 or more). The effects of vaginal GPRs, cervical dilatation, and previous history of preterm birth on the subsequent occurrence of birth were analyzed using proportional hazards model, and the effects on birth within seven days from the diagnosis of preterm labor were analyzed using multivariate logistic regression. RESULTS: Fifty-four women (42.9%) delivered preterm. Both loss of GPRs and decreased GPRs were independent risk factors for a short interval from threatened preterm labor to birth, after adjusting the effect of cervical dilatation and past history of preterm birth (hazard ratio 3.4 [95% CI 2.0-5.5] and 2.0 [95% CI 1.1-3.6], respectively). Cervical dilatation of <4.0 cm and 2.0-3.9 cm, and past history of preterm birth were also independent risk factors for a short interval to birth. Loss of GPRs and decreased GPRs, and cervical dilatation of <4.0 cm and 2.0-3.9 cm were independently associated with birth within seven days from the diagnosis of preterm labor (OR 26 [95% CI 5.3-130], 11 [1.9-69], 76 [8.0-720], and 6.4 [1.5-27], respectively). CONCLUSIONS: Loss of GPRs and decreased GPRs may be independently important for developing birth in women with preterm labor.
Authors:
Rie Usui; Akihide Ohkuchi; Shigeki Matsubara; Mitsuaki Suzuki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  37     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-23     Completed Date:  2010-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  244-50     Citation Subset:  IM    
Affiliation:
Jichi Medical University School of Medicine, Shimotsuke-shi, Tochigi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Colony Count, Microbial
Female
Gram-Positive Rods / isolation & purification*
Humans
Kaplan-Meiers Estimate
Labor Stage, First
Models, Statistical*
Obstetric Labor, Premature / microbiology*
Predictive Value of Tests
Pregnancy
Vagina / microbiology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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