Combs, C.A.; Zupancic, J.A.F.; Walker, M.; Shi, J. Prediction and Prevention of Preterm Birth: Secondary Analysis of a Randomized Intervention Trial. J. Clin. Med.2023, 12, 5459.
Combs, C.A.; Zupancic, J.A.F.; Walker, M.; Shi, J. Prediction and Prevention of Preterm Birth: Secondary Analysis of a Randomized Intervention Trial. J. Clin. Med. 2023, 12, 5459.
Combs, C.A.; Zupancic, J.A.F.; Walker, M.; Shi, J. Prediction and Prevention of Preterm Birth: Secondary Analysis of a Randomized Intervention Trial. J. Clin. Med.2023, 12, 5459.
Combs, C.A.; Zupancic, J.A.F.; Walker, M.; Shi, J. Prediction and Prevention of Preterm Birth: Secondary Analysis of a Randomized Intervention Trial. J. Clin. Med. 2023, 12, 5459.
Abstract
Our objective was to evaluate whether pregnancy is prolonged by use of a proteomics-based maternal serum screening test followed by treatment interventions. This is a secondary analysis of the PREVENT-PTB randomized trial comparing screening with the PreTRM test versus no screening. The primary trial analysis found no significant between-group difference in preterm birth rate. Rather than considering a dichotomous outcome (preterm vs term), we treated gestational age at birth as a continuous variable using survival analysis. We also evaluated between-group difference in NICU length of stay and duration of respiratory support. Results indicated that pregnancy was significantly prolonged in subjects screened with PreTRM test compared to controls (adjusted hazard ratio 0.53, 95% confidence interval 0.36-0.78, P <0.01). Newborns of screened subjects had significantly shorter NICU stay but no significant decrease in duration of respiratory support. In the PreTRM screen-positive group, interventions that were associated with pregnancy prolongation included care management and low-dose aspirin but not 17-hydroxyprogesterone caproate. We concluded that screening with the PreTRM test followed by interventions for screen-positive pregnancies can prolong pregnancy and reduce NICU-LOS.
Keywords
17-hydroxyprogesterone caproate; care management; length of stay; low-dose aspirin; neonatal respiratory morbidity; preterm birth; proteomic biomarkers; risk assessment
Subject
Medicine and Pharmacology, Obstetrics and Gynaecology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
