IDENTIFICATION OF PREDICTORS OF SPONTANEOUS EXTREMELY EARLY PRETERM BIRTH DUE TO PREMATURE RUPTURE OF MEMBRANES AND/OR CERVICAL INSUFFICIENCY: A RETROSPECTIVE SINGLE-CENTER COHORT STUDY
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Abstract
Despite numerous preventive measures, the number of preterm births has not changed in any country in the world over the past ten years.
Purpose of the study: to evaluate the prognostic significance of clinical, anamnestic, laboratory and instrumental risk factors for spontaneous extremely early preterm birth (EEPB) in pregnant women with premature rupture of membranes and/or cervical insufficiency based on a retrospective cohort single-center study.
Methods. During a study of the medical records of all spontaneous preterm births over a four-year period, risk factors for EEPB were analyzed, including clinical, anamnestic, laboratory, instrumental and physical parameters. The patients were divided into two groups: the study group( n = 116), delivery at 220-276 weeks of gestation; the comparison group (n = 950), delivery at 280-366 weeks of gestation. Univariate and multivariate binary logistic regression models were used to assess the impact of the studied factors on the timing of delivery. Differences between groups were considered significant at p < 0.05.
Results. The study revealed that the most significant risk factors for spontaneous EEPB due to cervical insufficiency and/or PROM are: «one or more recent miscarriages in the anamnesis», «polycystic ovary syndrome» and markers of the inflammatory process.
Conclusion. The predictive capabilities of the combination of clinical and anamnestic risk factors in the second trimester of pregnancy are superior to the first trimester prenatal combined screening model.
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