Risk factors and predictors of preterm delivery

Objective The aim of this study was to assess whether a combination of risk factors and predictors for preterm delivery, such as demographic data, cer vical score, serum ferritin, vaginal culture, fetal fibronectin test (fFN) and tocolytic treatment, was more useful than individual variables in ident ifying pregnancies with preterm delivery. Methods The study population included 94 asymptomatic women, with a gestati onal age of 24-27 weeks (by sonography data), receiving prenatal care in th e Gynecology and Obstetrics Institute of Padova University, at risk for pre term birth. The anamnestic risk factors were limited to previous preterm de livery and second-trimester abortion. The actual risk factors were limited to multiple gestation, prophylactic cervical cerclage, congenital uterine a nomaly, polyhydramnios, leiomyoma and intra uterine growth restriction. As a control group, 201 uncomplicated, symptom-free singleton pregnancies were enrolled from normal pregnant women. Statistical analysis was performed wi th bivariate frequency analysis (chi(2) test) and multiple logistic regress ion analysis. Results There was a statistically significant association between preterm b irth and maternal age (p = 0.004), previous preterm delivery (p = 0.004), p regnant status (p < 0.001), pelvic score (p < 0.001) and fFN test either ra pid (p < 0.001) or enzyme-linked immunosorbent assay (p < 0.001). By logist ic multiple regression analysis, we identified a logistic model, using preg nant status and fFN test, predicting a probability of preterm delivery rang ing from 16.1% (both predictors negative) to 96.4% (both predictors positiv e). Conclusion Our findings confirmed the usefulness of the fFN test in predict ing preterm delivery, especially in asymptomatic patients without risk fact ors. A positive fFN test might represent a marker of chorionic-decidual cel l activation.