Evaluation of a risk scoring system as a predictor of preterm birth in an indigent population

https://doi.org/10.1016/0002-9378(90)91086-RGet rights and content

Abstract

A risk scoring system designed to predict spontaneous preterm birth was implemented in a large, indigent population as part of a multicenter trial of preterm birth prevention. A total of 7478 women with singleton gestations were screened and followed up prospectively at the Birmingham project center. Patients who had an indicated preterm delivery or a fetal anomaly were excluded from the study population. Analysis by assigned risk score and parity showed that, whereas the sensitivity and positive predictive value were better in multiparous women than in nulliparous women, overall the values were low. Logistic regression analyses of the multiparous and nulliparous populations showed independent sets of significant (p ≤ 0.05) risk variables. A history of preterm delivery and a low prepregnancy weight were the most predictive risk factors in the multiparous and nulliparous models, respectively. We conclude that the clinical usefulness of a risk scoring system to predict spontaneous preterm birth in an indigent population is limited.

References (13)

There are more references available in the full text version of this article.

Cited by (43)

  • Harnessing the potential of artificial neural networks for pediatric patient management

    2020, Artificial Intelligence in Medicine: Technical Basis and Clinical Applications
  • Early prediction of preterm birth for singleton, twin, and triplet pregnancies

    2007, European Journal of Obstetrics and Gynecology and Reproductive Biology
    Citation Excerpt :

    It could help in guiding treatment with antenatal steroids on appropriate patients in a timely fashion, and in directing tertiary care referrals. Previous studies have used various strategies to predict preterm birth, including risk scoring systems [4,5], biochemical markers such as fetal fibronectin [6], salivary estriol [7], transvaginal sonography [8], vaginal infections [9], clinical characteristics (bleeding, substance abuse, white blood cell count ≥14,000 cells/μl, and frequency of uterine contractions) [10–11], and data mining methods [12] in singletons and/or twins. The sensitivity of these methods was only about 40%, and the positive predictive value (PPV) was usually lower than 30% [4,11].

View all citing articles on Scopus

Presented at the Tenth Annual Meeting of the Society of Perinatal Obstetricians, Houston, Texas, January 23–27, 1990.

View full text