title: Effect of obesity on preterm delivery prediction by transabdominal recording of uterine electromyography.
abstract: OBJECTIVE
  It has been shown that noninvasive uterine electromyography (EMG) can identify true preterm labor more accurately than methods available to clinicians today. The objective of this study was to evaluate the effect of body mass index (BMI) on the accuracy of uterine EMG in predicting preterm delivery.
  
  
  METHODS
  Predictive values of uterine EMG for preterm delivery were compared in obese versus overweight/normal BMI patients. Hanley-McNeil test was used to compare receiver operator characteristics curves in these groups. Previously reported EMG cutoffs were used to determine groups with false positive/false negative and true positive/true negative EMG results. BMI in these groups was compared with Student t test (p < 0.05 significant).
  
  
  RESULTS
  A total of 88 patients were included: 20 obese, 64 overweight, and four with normal BMI. EMG predicted preterm delivery within 7 days with area under the curve = 0.95 in the normal/overweight group, and with area under the curve = 1.00 in the obese group (p = 0.08). Six patients in true preterm labor (delivering within 7 days from EMG measurement) had low EMG values (false negative group). There were no false positive results. No significant differences in patient's BMI were noted between false negative group patients and preterm labor patients with high EMG values (true positive group) and nonlabor patients with low EMG values (true negative group; p = 0.32).
  
  
  CONCLUSIONS
  Accuracy of noninvasive uterine EMG monitoring and its predictive value for preterm delivery are not affected by obesity.
authors.affiliation: Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA; Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, Slovenia.
authors.forename: Miha
authors.initials: M
authors.lastname: Lucovnik
authors.affiliation: Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
authors.forename: Linda R
authors.initials: LR
authors.lastname: Chambliss
authors.affiliation: Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Blumrick
authors.affiliation: Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
authors.forename: James
authors.initials: J
authors.lastname: Balducci
authors.affiliation: Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, Slovenia.
authors.forename: Ksenija
authors.initials: K
authors.lastname: Gersak
authors.affiliation: Department of Obstetrics and Gynecology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Electronic address: drrobertgarfield@gmail.com.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Garfield
mesh_terms: D000293:Adolescent; D000328:Adult; D004576:Electromyography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009765:Obesity / Q000150:complications*; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications; D047928:Premature Birth / Q000175:diagnosis* / Q000209:etiology; D012372:ROC Curve; D012189:Retrospective Studies; D014590:Uterine Contraction / Q000502:physiology*; D018590:Uterine Monitoring / Q000379:methods*
keywords: electrohysterography; obesity; preterm birth; preterm labor; uterine electromyography