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    Predicting Premature Delivery

    By
    WebMD Health News
    Reviewed by Gary D. Vogin, MD

    Jan. 23, 2002 -- Does monitoring the frequency of uterine contractions predict whether a woman will give birth prematurely? The question has been studied for two decades with mixed findings, but new research suggests the answer is an emphatic "no."

    Researchers from the National Institute of Child Health and Human Development's Network of Maternal-Fetal Medicine evaluated the usefulness of an at-home contraction-monitoring device in a group of pregnant women at high risk for premature delivery. While there were slight differences in contraction frequency between women who later gave birth prematurely and those who did not, these differences were not useful for predicting what would happen.

    The findings are published in the Jan. 24 issue of The New England Journal of Medicine.

    Researchers have long been frustrated in their efforts to both predict and prevent early births. The finding from this and earlier studies suggest that the strategy of detecting contractions and suppressing them is not useful, lead author Jay D. Iams, MD, tells WebMD. Iams is a professor of obstetrics and gynecology at Ohio State University.

    "This two-decades-old strategy has been discredited, and we are really going back to the drawing board in our efforts to identify women who will give birth prematurely," he says. "We do have tests that allow us to reassure high-risk women with reasonable accuracy, but when it comes to predicting who will deliver early, there is really nothing out there."

    Approximately one in 10 babies in the United States is born prematurely and some 5,000 infants die each year due to complications of premature birth. Risk factors for early delivery include carrying multiples (twins, triplets, etc.), having a previous child born prematurely, and uterine bleeding during the second trimester. But only about half of women who give birth prematurely are considered to be at high risk.

    Iams and colleagues found a slight increase in the frequency of uterine contractions in the high-risk study participants who later delivered prematurely, but the finding had little predictive value. Measures that were more helpful included cervical length (measured with ultrasound), and presence of a substance called fetal fibronectin in the mother's vaginal secretions.

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