title: A proposed method to predict preterm birth using clinical data, standard maternal serum screening, and cholesterol.
abstract: OBJECTIVE
  The objective of the study was to create a predictive model for preterm birth (PTB) from available clinical data and serum analytes.
  
  
  METHODS
  Serum analytes and routine pregnancy screening plus cholesterol and corresponding health information were linked to birth certificate data for a cohort of 2699 Iowa women with serum sampled in the first and second trimester. Stepwise logistic regression was used to select the best predictive model for PTB.
  
  
  RESULTS
  Serum screening markers remained significant predictors of PTB, even after controlling for maternal characteristics. The best predictive model included maternal characteristics, first-trimester total cholesterol, total cholesterol change between trimesters, and second-trimester alpha-fetoprotein and inhibin A. The model showed better discriminatory ability than PTB history alone and performed similarly in subgroups of women without past PTB.
  
  
  CONCLUSIONS
  Using clinical and serum screening data, a potentially useful predictor of PTB was constructed. Validation and replication in other populations, and incorporation of other measures that identify PTB risk, like cervical length, can be a step toward identifying additional women who may benefit from new or currently available interventions.
authors.affiliation: Department of Pediatrics, University of Iowa School of Medicine, Iowa City, IA 52242, USA.
authors.forename: Brandon W
authors.initials: BW
authors.lastname: Alleman
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Smith
authors.forename: Heather M
authors.initials: HM
authors.lastname: Byers
authors.forename: Bruce
authors.initials: B
authors.lastname: Bedell
authors.forename: Kelli K
authors.initials: KK
authors.lastname: Ryckman
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Murray
authors.forename: Kristi S
authors.initials: KS
authors.lastname: Borowski
mesh_terms: D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007484:Iowa; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000097:blood / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D000509:alpha-Fetoproteins; C422362:inhibin A; D007265:Inhibins; D002784:Cholesterol