What is the risk of preterm delivery after arrested preterm labor?
OBJECTIVE
The aim of this study is to assess if women with arrested preterm labor (PTL) have an increased risk of preterm delivery (PTD) compared with healthy pregnant women, and if digital examination, fetal fibronectin (fFn) and cervical length (CL) are prognostic markers for PTD after arrested PTL.


METHODS
Prospective-matched cohort study among women with arrested PTL (cases) and healthy pregnant women (controls).


RESULTS
We included 74 index cases and 74 controls. PTD occurred in 20 (27%) index cases and in 5 (7%) controls (hazard ratio [HR], 4.5; 95% confidence interval [CI], 1.7-12). A dilatation of the cervix ≥ 1 cm (HR, 9.1 [95% CI, 3.3-25], an fFn positive status (HR, 13 [95% CI, 4.3-40]), and a CL < 15 mm (HR, 11 [95% CI, 3.1-38]) increased this risk in cases compared with controls. Knowledge of the fFn result had additional value over the cervical dilatation or CL in the prediction of persistent PTD, with an increased risk in case of a positive fFn test.


CONCLUSIONS
Women stay at increased risk for PTD after arrested PTL. This risk further increased in case of ≥ 1 cm cervical dilatation, CL < 15 mm and/or a positive fFn status.
Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands.
Femke F
FF
Wilms
Department of Clinical Chemistry and Hematology, University Medical Center, Utrecht, The Netherlands.
Jolande Y
JY
Vis
Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands.
Laura
L
de Wit-Zuurendonk
Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands.
Martina M
MM
Porath
The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia.
Ben Willem J
BW
Mol
D000328:Adult; D016022:Case-Control Studies; D054791:Cervical Length Measurement; D002584:Cervix Uteri; D015331:Cohort Studies; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D009543:Nifedipine / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D010808:Physical Examination; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D015149:Tocolytic Agents / Q000627:therapeutic use*
C403421:FFN protein, human; D005353:Fibronectins; D015149:Tocolytic Agents; D009543:Nifedipine