title: The preterm prediction study: the value of new vs standard risk factors in predicting early and all spontaneous preterm births. NICHD MFMU Network.
abstract: OBJECTIVE
  This study was undertaken to determine the relationship between fetal fibronectin, short cervix, bacterial vaginosis, other traditional risk factors, and spontaneous preterm birth.
  
  
  METHODS
  From 1992 through 1994, 2929 women were screened at the gestational age 22 to 24 weeks.
  
  
  RESULTS
  The odds ratios for spontaneous preterm birth were highest for fetal fibronectin, followed by a short cervix and history of preterm birth. These factors, as well as bacterial vaginosis, were more strongly associated with early than with late spontaneous preterm birth. Bacterial vaginosis was more common--and a stronger predictor of spontaneous preterm birth--in Black women, while body mass index less than 19.8 was a stronger predictor in non-Black women. This analysis suggests a pathway leading from Black race through bacterial vaginosis and fetal fibronectin to spontaneous preterm birth. Prior preterm birth is associated with spontaneous preterm birth through a short cervix.
  
  
  CONCLUSIONS
  Fetal fibronectin and a short cervix are stronger predictors of spontaneous preterm birth than traditional risk factors. Bacterial vaginosis was found more often in Black than in non-Black women and accounted for 40% of the attributable risk for spontaneous preterm birth at less than 32 weeks.
authors.affiliation: University of Alabama at Birmingham, Department of Obstetrics and Gynecology 35294-7333, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Goldenberg
authors.forename: J D
authors.initials: JD
authors.lastname: Iams
authors.forename: B M
authors.initials: BM
authors.lastname: Mercer
authors.forename: P J
authors.initials: PJ
authors.lastname: Meis
authors.forename: A H
authors.initials: AH
authors.lastname: Moawad
authors.forename: R L
authors.initials: RL
authors.lastname: Copper
authors.forename: A
authors.initials: A
authors.lastname: Das
authors.forename: E
authors.initials: E
authors.lastname: Thom
authors.forename: F
authors.initials: F
authors.lastname: Johnson
authors.forename: D
authors.initials: D
authors.lastname: McNellis
authors.forename: M
authors.initials: M
authors.lastname: Miodovnik
authors.forename: J P
authors.initials: JP
authors.lastname: Van Dorsten
authors.forename: S N
authors.initials: SN
authors.lastname: Caritis
authors.forename: G R
authors.initials: GR
authors.lastname: Thurnau
authors.forename: S F
authors.initials: SF
authors.lastname: Bottoms
mesh_terms: D002584:Cervix Uteri / Q000033:anatomy & histology; D005260:Female; D005312:Fetal Blood; D005353:Fibronectins / Q000097:blood; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D011247:Pregnancy; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D016585:Vaginosis, Bacterial
chemical_list: D005353:Fibronectins