Maternal preterm birth prediction in the United States: a case-control database study.

BMC Pediatr

Department of Obstetrics and Gynecology, Beijing Haidian Maternal and Child Healthcare Hospital, NO.33 Haidian South Road, Haidian District, Beijing, 100080, China.

Published: September 2022

AI Article Synopsis

  • Preterm birth poses a significant global public health issue, and this study focuses on creating a prediction model to help identify at-risk pregnant women for timely interventions.* -
  • Analyzed data from over 3 million pregnant women utilized logistic regression to determine risk factors for preterm birth, revealing that education, weight, and prenatal care reduce risk, while older age, race, certain health conditions, and lifestyle choices increase it.* -
  • The developed prediction model showed an area under the curve (AUC) of 0.688, indicating moderate performance in predicting the likelihood of preterm births among the tested population.*

Article Abstract

Background: Preterm birth is serious public health worldwide, and early prediction of preterm birth in pregnant women may provide assistance for timely intervention and reduction of preterm birth. This study aimed to develop a preterm birth prediction model that is readily available and convenient for clinical application.

Methods: Data used in this case-control study were extracted from the National Vital Statistics System (NVSS) database between 2018 and 2019. Univariate and multivariate logistic regression analyses were utilized to find factors associated with preterm birth. Odds ratio (OR) and 95% confidence interval (CI) were used as effect measures. The area under the curve (AUC), accuracy, sensitivity, and specificity were utilized as model performance evaluation metrics.

Results: Data from 3,006,989 pregnant women in 2019 and 3,039,922 pregnant women in 2018 were used for the model establishment and external validation, respectively. Of these 3,006,989 pregnant women, 324,700 (10.8%) had a preterm birth. Higher education level of pregnant women [bachelor (OR = 0.82; 95%CI, 0.81-0.84); master or above (OR = 0.82; 95%CI, 0.81-0.83)], pre-pregnancy overweight (OR = 0.96; 95%CI, 0.95-0.98) and obesity (OR = 0.94; 95%CI, 0.93-0.96), and prenatal care (OR = 0.48; 95%CI, 0.47-0.50) were associated with a reduced risk of preterm birth, while age ≥ 35 years (OR = 1.27; 95%CI, 1.26-1.29), black race (OR = 1.26; 95%CI, 1.23-1.29), pre-pregnancy underweight (OR = 1.26; 95%CI, 1.22-1.30), pregnancy smoking (OR = 1.27; 95%CI, 1.24-1.30), pre-pregnancy diabetes (OR = 2.08; 95%CI, 1.99-2.16), pre-pregnancy hypertension (OR = 2.22; 95%CI, 2.16-2.29), previous preterm birth (OR = 2.95; 95%CI, 2.88-3.01), and plurality (OR = 12.99; 95%CI, 12.73-13.24) were related to an increased risk of preterm birth. The AUC and accuracy of the prediction model in the testing set were 0.688 (95%CI, 0.686-0.689) and 0.762 (95%CI, 0.762-0.763), respectively. In addition, a nomogram based on information on pregnant women and their spouses was established to predict the risk of preterm birth in pregnant women.

Conclusions: The nomogram for predicting the risk of preterm birth in pregnant women had a good performance and the relevant predictors are readily available clinically, which may provide a simple tool for the prediction of preterm birth.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472432PMC
http://dx.doi.org/10.1186/s12887-022-03591-wDOI Listing

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