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J Clin Epidemiol. 2005 Mar;58(3):304-10.

A cohort study found that white blood cell count and endocrine markers predicted preterm birth in symptomatic women.

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  • 1Department of Epidemiology and Biostatistics, University of Western Ontario, Kresge Building, London, Ontario, Canada. karen.campbell@fmd.uwo.ca

Abstract

OBJECTIVE:

This cohort study investigated potential clinical and biochemical predictors of subsequent preterm birth in women presenting with threatened preterm labor.

STUDY DESIGN AND SETTING:

Subjects were 218 pregnant women admitted to hospital with a diagnosis of threatened preterm labor at 22-36 weeks gestation. Exclusion criteria were multiple pregnancy, fetal anomalies, diabetes mellitus, abruptio placenta, preeclampsia, intrauterine growth restriction, cervical dilatation > 4 cm, and clinical signs of infection. Analyses used logistic regression.

RESULTS:

The presence of ruptured membranes was the best predictor of birth within 48 hours. Other important predictors were maternal white blood cell count at 22-27 weeks gestation and maternal adrenocorticotropin and corticotropin-releasing hormone concentrations at 28-36 weeks gestation.

CONCLUSION:

Subclinical infection may be an important etiologic factor in preterm births of gestational age < 28 weeks. For those at > or = 28 weeks gestation, the findings support the etiologic role of activation of the fetal and/or maternal hypothalamic pituitary adrenal axis leading to preterm birth.

[PubMed - indexed for MEDLINE]
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