THE PRETERM PREDICTION STUDY - THE VALUE OF NEW VS STANDARD RISK-FACTORS IN PREDICTING EARLY AND ALL SPONTANEOUS PRETERM BIRTHS

Objective. This study was undertaken to determine the relationship bet ween fetal fibronectin, short cervix, bacterial vaginosis, other tradi tional risk factors, and spontaneous preterm birth. Methods. From 1992 through 1994, 2929 women were screened at the gestational age of 22 t o 24 weeks. Results. The odds ratios for spontaneous preterm birth wer e highest for fetal fibronectin, followed by a short cervix and histor y of preterm birth. These factors, as well as bacterial vaginosis, wer e more strongly associated with early than with late spontaneous prete rm birth. Bacterial vaginosis was more common-and a stronger predictor of spontaneous preterm birth-in Black women, while body mass index le ss than 19.8 was a stronger predictor in non-Black women. This analysi s suggests a pathway leading from Black race through bacterial vaginos is and fetal fibronectin to spontaneous preterm birth. Prior preterm b irth is associated with spontaneous preterm birth through a short cerv ix. Conclusions. Fetal fibronectin and a short cervix are stronger pre dictors of spontaneous preterm birth than traditional risk factors. Ba cterial vaginosis was found more often in Black than in non-Black wome n and accounted for 40% of the attributable risk for spontaneous prete rm birth at less than 32 weeks.