Editorial

Predicting spontaneous preterm birth

BMJ 2002; 325 doi: 10.1136/bmj.325.7359.289 (Published 10 August 2002)
Cite this as: BMJ 2002;325:289

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Fetal fibronectin and ultrasonography help to rule out labour, not rule it in

  1. David F Colombo, assistant professor (Colombo.4@osu.edu)
  1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus, OH 43210, USA

    Papers p 301

    The literature on predicting spontaneous preterm delivery deals with two areas. The first is predicting preterm delivery in asymptomatic patients. This is the risk you tell a woman in mid pregnancy when she asks you if she will deliver early. The second concerns symptomatic patients. These are women who report contractions between 24 and 36 weeks of gestation. To separate the two in theliterature is difficult because both sets of data involve the same terminology and tests. The reader must therefore be aware of the populations being studied. The predictive values for any test are directly related to the incidence of the disease in the population studied. Therefore, a test that is predictive in a higher risk group may be of little use in the general population.

    The initial attempts to predict preterm delivery in asymptomatic patients involved the use of risk factors in patients. These produced the Creasy risk scoring system.1 This system was able to predict two thirds of those who delivered prematurely in a middle …

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