Is routine infectious and toxicologic screening in preterm labor effective in predicting preterm birth?
OBJECTIVE
Our objective was to evaluate whether a significant association exists between cocaine use, cervical, urine, and/or Group B streptococcus (GBS) infections and preterm birth (PTB) in patients admitted with active preterm labor (PTL).


METHODS
A retrospective cohort study of PTL patients < 34 weeks (n = 400) admitted to a large, urban tertiary care hospital (2002-2005) was performed. Pertinent history and screening test results were collected. The prevalence of a positive result for each test was determined. Pearson chi-square and Poisson regression were used to evaluate the significance of associations between screening tests and PTB and to control for confounders.


RESULTS
The percentage of patients that delivered at < 37 and < 34 weeks was 63.5% (n = 254) and 44.5% (n = 178), respectively. Only cocaine use was significantly associated with PTB at < 34 weeks (RR 1.86, 95%CI 1.03, 2.08).


CONCLUSIONS
This laboratory test panel is not an effective adjunctive means to predict PTB in PTL patients.
Bastek
Jamie A
JA
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
Sammel
Mary D
MD
Srinivas
Sindhu K
SK
Elovitz
Michal A
MA
D000328:Adult; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000453:epidemiology* / Q000382:microbiology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000382:microbiology; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology; D013292:Streptococcus agalactiae