Environmental variables as potential modifiable risk factors of preterm birth in Philadelphia, PA.

Objective: To examine whether variation in neighborhood context is associated with preterm birth (PTB) outcomes and gestational age (GA) at delivery in Philadelphia, and to determine whether these associations might persist when considering relevant individual-level variables.

Study Design: We analyzed individual-level data collected for a prospective cohort study of singleton pregnancies with preterm labor. We merged block-group level data to each individual's home address.

Prenatal inflammation is associated with adverse neonatal outcomes.

Objective: The purpose of this study was to determine whether prenatal inflammation (as assessed by clinical chorioamnionitis, maternal temperature >38°C, or histologic chorioamnionitis) is associated with a composite adverse neonatal outcome.

Study Design: We performed a prospective cohort study of women at 22 weeks to 33 weeks 6 days' gestation with symptoms of labor (April 2009 to March 2012). Relevant maternal and neonatal exposures and outcomes were recorded.

Biomarkers and cervical length to predict spontaneous preterm birth in asymptomatic high-risk women.

Objective: To investigate whether biomarkers from different pathways of spontaneous preterm birth (cervical membrane degradation [fetal fibronectin], cervical remodeling [soluble E-cadherin], and inflammation (elafin, surfactant protein-D, interleukin-6 [IL-6]) were superior to one biomarker alone in predicting preterm birth. Our secondary objective was to examine the association of these biomarkers with cervical length in predicting preterm birth.

Methods: We performed a single-center, prospective cohort study from August 2011 to November 2012 of asymptomatic women at risk for spontaneous preterm birth as a result of obstetric and gynecologic history.

Clinical prediction rules for preterm birth in patients presenting with preterm labor.

Objective: To develop prediction rules to identify which women with preterm labor are at greatest risk for delivery within 10 days and before 37 weeks of gestation using demographic and clinical risk factors alone.

Methods: We analyzed data collected for a prospective cohort study of singleton pregnancies at 22-33 6/7 weeks of gestation with preterm labor. Potential risk factors were included in multivariable logistic models for each outcome.

The soluble receptor for advanced glycation end products can prospectively identify patients at greatest risk for preterm birth.

Objective: Our primary objective was to determine whether there was an association between levels of antenatal maternal serum soluble RAGE (sRAGE), drawn at the time of presentation with preterm labor (PTL), and subsequent preterm birth (PTB). Secondary objectives were to determine whether levels of sRAGE - analyzed from both antenatal maternal serum (MS) and postpartum umbilical cord serum (CS) - were associated with neonatal sepsis.

Methods: Nested case-control analyses were performed within a prospective cohort of patients at risk for PTB.