Video: Population-Based Risk Scoring Predicts Preterm Birth Risks Earlier than Cervical Length Screening Followed By Fetal Fibronectin Testing

'Population Based Risk Scoring Can Effectively Predict Preterm Birth Risks Earlier than Cervical Length Screening Followed By Fetal Fibronectin Testing'was presented by Jerasimos Ballas, MD, MPH, during a poster session at the American Congress of Obstetricians and Gynecologists' Annual Clinical Meeting. Watch the video or read the transcript, below.

Hello. Jerasimos Ballas, I’m actually currently at University of San Diego, California. This project was done as a resident at Stonybrook in eastern New York. The title is “Population Based Risk Scoring Can Effectively Predict Preterm Birth Earlier than Cervical Length Screening and Fetal Fibronectin Testing.” So basically the concept behind this is actually not a new concept but something that [Creasy] came out with in the late ‘70s early ‘80s where the predictor risk of preterm birth we could do pretty accurately with history, past obstetrics history, current risk factors, socioeconomic status, ethnic diversity, all of that could be taken into account and come up with a risk score. Unfortunately back in the day, they really had nothing to either prevent or monitor accurately. So throughout the next couple decades when we came out with more methods of detecting preterm birth. We kind of got away from primary prevention until progesterone came back around. Currently progesterone is limited to a woman with a history of spontaneous preterm birth. So we started looking at a way of possibly broadening that recommendation to include women with factors that can also lead to preterm birth that wouldn’t necessarily be called with only a history of preterm birth in the past.

So we came up with simple questionnaire, which was presented in the first trimester. So before even cervical length screening could come into account, before fetal fibronectin really becomes an issue, this is a woman coming into any practitioner’s office. And these factors go into a woman’s obstetrical past, but also go into socioeconomic issues, current health status, even something like gum disease, which we know has an association with preterm birth but not necessarily a strong association. So, when we look at individual factors, we do find a few factors that in and of themselves have a small association with preterm birth. And when we sum the weighted scores of each factor, we come up with a significant score greater than six that doesn’t necessarily always include history of preterm birth or obstetric history. So the significance pretty much comes down to, are we missing a good swath of women who are going to deliver preterm that we could potentially give a primary preventive method like progesterone to. So that’s what it comes down to.