Wilms Femke F, Vis Jolande Y, de Wit-Zuurendonk Laura, Porath Martina M, Mol Ben Willem J
Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands.
Department of Clinical Chemistry and Hematology, University Medical Center, Utrecht, The Netherlands.
Am J Perinatol. 2015 Jan;32(1):63-70. doi: 10.1055/s-0034-1374818. Epub 2014 May 16.
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.
Prospective-matched cohort study among women with arrested PTL (cases) and healthy pregnant women (controls).
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.
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.
本研究旨在评估与健康孕妇相比，早产临产（PTL）停滞的女性发生早产（PTD）的风险是否增加，以及指诊、胎儿纤连蛋白（fFn）和宫颈长度（CL）是否为PTL停滞后PTD的预后标志物。
对PTL停滞的女性（病例组）和健康孕妇（对照组）进行前瞻性匹配队列研究。
我们纳入了74例索引病例和74例对照。20例（27%）索引病例和5例（7%）对照发生了PTD（风险比[HR]，4.5；95%置信区间[CI]，1.7 - 12）。与对照组相比，宫颈扩张≥1 cm（HR，9.1 [95% CI，3.3 - 25]）、fFn阳性状态（HR，13 [95% CI，4.3 - 40]）和CL < 15 mm（HR，11 [95% CI，3.1 - 38]）会增加病例组的这种风险。在预测持续性PTD方面，了解fFn结果比宫颈扩张或CL具有更大的价值，fFn检测呈阳性时风险增加。
PTL停滞的女性发生PTD的风险增加。在宫颈扩张≥1 cm、CL < 15 mm和/或fFn状态为阳性的情况下，这种风险会进一步增加。
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