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. 2015 Oct 22;2015(10):CD004902.
doi: 10.1002/14651858.CD004902.pub5.

Risk-scoring systems for predicting preterm birth with the aim of reducing associated adverse outcomes

Mary-Ann Davey  1 , Lyndsey Watson, Jo Anne Rayner, Shelley Rowlands
Affiliations

Risk-scoring systems for predicting preterm birth with the aim of reducing associated adverse outcomes

Mary-Ann Davey et al. Cochrane Database Syst Rev. .

Abstract

Background: Identification of pregnancies that are higher risk than average is important to allow the possibility of interventions aimed at preventing adverse outcomes like preterm birth. Many scoring systems designed to classify the risk of a number of poor pregnancy outcomes (e.g. perinatal mortality, low birthweight, and preterm birth) have been developed, but they have usually been introduced without evaluation of their utility and validity.

Objectives: To determine whether the use of a risk-screening tool designed to predict preterm birth (in combination with appropriate consequent interventions) reduces the incidence of preterm birth and very preterm birth, and associated adverse outcomes.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2015).

Selection criteria: All randomised or quasi-randomised (including cluster-randomised) or controlled clinical trials that compared the incidence of preterm birth between groups that used a risk-scoring instrument to predict preterm birth with those who used an alternative instrument, or no instrument; or that compared the use of the same instrument at different gestations. The reports may have been published in peer reviewed or non-peer reviewed publications, or not published, and written in any language.

Data collection and analysis: All review authors planned to independently assess for inclusion all the potential studies we identified as a result of the search strategy. However, we did not identify any eligible studies.

Main results: Searching revealed no trials of the use of risk-scoring systems for preventing preterm birth.

Authors' conclusions: The role of risk-scoring systems in the prevention of preterm birth is unknown.There is a need for prospective studies that evaluate the use of a risk-screening tool designed to predict preterm birth (in combination with appropriate consequent interventions) to prevent preterm birth, including qualitative and/or quantitative evaluation of their impact on women's well-being. If these prove promising, they should be followed by an adequately powered, well-designed randomised controlled trial.

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Conflict of interest statement

None known.

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References

Additional references

Alexander 1989
    1. Alexander S, Keirse M. Formal risk scoring during pregnancy. In: Chalmers I, Enkin M, Keirse M editor(s). Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press, 1989.
Ananth 2005
    1. Ananth CV, Joseph KS, Oyelese Y, Demissie K, Vintzileos AM. Trends in preterm birth and perinatal mortality among singletons: United States, 1989 through 2000. Obstetrics and Gynecology 2005;105(5 Pt 1):1084‐91. [PUBMED: 15863548] - PubMed
Andermann 2008
    1. Andermann A, Blancquaert I, Beauchamp S, Dery V. Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bulletin of the World Health Organization 2008;86(4):317‐9. - PMC - PubMed
Anderson 2004
    1. Anderson PJ, Doyle LW. Executive functioning in school‐aged children who were born very preterm or with extremely low birth weight in the 1990s. Pediatrics 2004;114(1):50‐7. [PUBMED: 15231907] - PubMed
Berkowitz 1993
    1. Berkowitz GS, Papiernik E. Epidemiology of preterm birth. Epidemiologic Reviews 1993;15:141‐3. - PubMed
Buitendijk 2003
    1. Buitendijk S, Zeitlin J, Cuttini M, Langhoff‐Roos J, Bottu J. Indicators of fetal and infant health outcomes. European Journal of Obstetrics & Gynecology and Reproductive Biology 2003;111 Suppl 1:S66‐S77. [PUBMED: 14642321] - PubMed
Costeloe 2006
    1. Costeloe K. EPICure: facts and figures: why preterm labour should be treated. BJOG: an international journal of obstetrics and gynaecology 2006;113 Suppl 3:10‐2. [PUBMED: 17206960] - PubMed
Creasy 1980
    1. Creasy RK, Gummer BA, Liggins GC. System for predicting spontaneous preterm birth. Obstetrics and Gynecology 1980;55:692‐5. - PubMed
Crowther 2010
    1. Crowther CA, Han S. Hospitalisation and bed rest for multiple pregnancy. Cochrane Database of Systematic Reviews 2010, Issue 7. [DOI: 10.1002/14651858.CD000110] - DOI - PMC - PubMed
Crowther 2015
    1. Crowther CA, McKinlay CJD, Middleton P, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. Cochrane Database of Systematic Reviews 2015, Issue 7. [DOI: 10.1002/14651858.CD003935] - DOI - PMC - PubMed
Davis 2007
    1. Davis NM, Ford GW, Anderson PJ, Doyle LW. Developmental coordination disorder at 8 years of age in a regional cohort of extremely‐low‐birthweight or very preterm infants. Developmental Medicine and Child Neurology 2007;49(5):325‐30. [PUBMED: 17489804] - PubMed
Doyle 2001a
    1. Doyle LW, Casalaz D. Outcome at 14 years of extremely low birthweight infants: a regional study. Archives of Disease in Childhood. Fetal and Neonatal Edition 2001;85(3):F159‐F164. [PUBMED: 11668155] - PMC - PubMed
Doyle 2001b
    1. Doyle LW. Outcome at 5 years of age of children 23 to 27 weeks' gestation: refining the prognosis. Pediatrics 2001;108(1):134‐41. [PUBMED: 11433066] - PubMed
Doyle 2003
    1. Doyle LW, Faber B, Callanan C, Morley R. Blood pressure in late adolescence and very low birth weight. Pediatrics 2003;111(2):252‐7. [PUBMED: 12563047] - PubMed
Doyle 2005
    1. Doyle LW, Anderson PJ. Improved neurosensory outcome at 8 years of age of extremely low birthweight children born in Victoria over three distinct eras. Archives of Disease in Childhood. Fetal and Neonatal Edition 2005;90(6):F484‐F488. [PUBMED: 15899930] - PMC - PubMed
Doyle 2006
    1. Doyle LW, Faber B, Callanan C, Freezer N, Ford GW, Davis NM. Bronchopulmonary dysplasia in very low birth weight subjects and lung function in late adolescence. Pediatrics 2006;118(1):108‐13. [PUBMED: 16818555] - PubMed
Fedrick 1976
    1. Fedrick J, Anderson ABM. Factors associated with spontaneous preterm birth. British Journal of Obstetrics and Gynaecology 1976;83:342‐50. - PubMed
Fedrick 1976a
    1. Fedrick J. Antenatal identification of women at high risk of spontaneous preterm birth. British Journal of Obstetrics and Gynaecology 1976;83:351‐4. - PubMed
Flenady 2013
    1. Flenady V, Hawley G, Stock OM, Kenyon S, Badawi N. Prophylactic antibiotics for inhibiting preterm labour with intact membranes. Cochrane Database of Systematic Reviews 2013, Issue 12. [DOI: 10.1002/14651858.CD000246] - DOI - PMC - PubMed
Ford 2000
    1. Ford GW, Doyle LW, Davis NM, Callanan C. Very low birth weight and growth into adolescence. Archives of Pediatrics and Adolescent Medicine 2000;154(8):778‐84. [PUBMED: 10922273] - PubMed
Gilbert 2006
    1. Gilbert WM. The cost of preterm birth: the low cost versus high value of tocolysis. BJOG: an international journal of obstetrics and gynaecology 2006;113 Suppl 3:4‐9. [PUBMED: 17206959] - PubMed
Hack 2004
    1. Hack M, Youngstrom EA, Cartar L, Schluchter M, Taylor HG, Flannery D, et al. Behavioral outcomes and evidence of psychopathology among very low birth weight infants at age 20 years. Pediatrics 2004;114(4):932‐40. [PUBMED: 15466087] - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hodnett 2010
    1. Hodnett ED, Fredericks S, Weston J. Support during pregnancy for women at increased risk of low birthweight babies. Cochrane Database of Systematic Reviews 2010, Issue 6. [DOI: 10.1002/14651858.CD000198.pub2] - DOI - PubMed
Honest 2004
    1. Honest H, Bachmann LM, Sundaram R, Gupta JK, Kleijnen J, Khan KS. The accuracy of risk scores in predicting preterm birth ‐ a systematic review. Journal of Obstetrics and Gynaecology 2004;24(4):343‐59. - PubMed
Honest 2009
    1. Honest H, Forbes CA, Duree KH, Norman G, Duffy SB, Tsourapas A, et al. Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling. Health Technology Assessment (Winchester, England) 2009;13(43):1‐627. [PUBMED: 19796569] - PubMed
Johnston 2001
    1. Johnston RB Jr, Williams MA, Hogue CJ, Mattison DR. Overview: new perspectives on the stubborn challenge of preterm birth. Paediatric and Perinatal Epidemiology 2001;15 Suppl 2:3‐6. [PUBMED: 11520395] - PubMed
Jordan 2009
    1. Jordan RG, Murphy PA. Risk assessment and risk distortion: finding the balance. Journal of Midwifery and Women's Health 2009;54(3):191‐200. - PubMed
Joseph 2007
    1. Joseph KS. Theory of obstetrics: an epidemiologic framework for justifying medically indicated early delivery. BMC Pregnancy and Childbirth 2007;7:4. [PUBMED: 17391525] - PMC - PubMed
Kramer 1987
    1. Kramer MS. Determinants of low birth weight: methodological assessment and meta‐analysis. Bulletin of the World Health Organization 1987;65(5):663‐737. [PUBMED: 3322602] - PMC - PubMed
Kramer 2001
    1. Kramer MS, Goulet L, Lydon J, Seguin L, McNamara H, Dassa C, et al. Socio‐economic disparities in preterm birth: causal pathways and mechanisms. Paediatric and Perinatal Epidemiology 2001;15 Suppl 2:104‐23. [PUBMED: 11520404] - PubMed
Lambotte 1977
    1. Lambotte R. Discussion. In: Anderson A editor(s). Pre‐term Labour. Proceedings of the Fifth Study Group of the Royal College of Obstetricians and Gynaecologists. Royal College of Obstetricians and Gynaecologists, 1977:40‐1.
Larroque 2008
    1. Larroque B, Ancel PY, Marret S, Marchand L, Andre M, Arnaud C, et al. Neurodevelopmental disabilities and special care of 5‐year‐old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet 2008;371(9615):813‐20. [PUBMED: 18328928] - PubMed
Lumley 1993
    1. Lumley J. The epidemiology of preterm birth. Bailliere's Clinical Obstetrics and Gynaecology 1993;7:477‐98. - PubMed
Petrou 2003
    1. Petrou S, Mehta Z, Hockley C, Cook‐Mozaffari P, Henderson J, Goldacre M. The impact of preterm birth on hospital inpatient admissions and costs during the first 5 years of life. Pediatrics 2003;112(6 Pt 1):1290‐7. [PUBMED: 14654599] - PubMed
Petrou 2006
    1. Petrou S, Henderson J, Bracewell M, Hockley C, Wolke D, Marlow N. Pushing the boundaries of viability: the economic impact of extreme preterm birth. Early Human Development 2006;82(2):77‐84. [PUBMED: 16466865] - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Riley 2008
    1. Riley K, Roth S, Sellwood M, Wyatt JS. Survival and neurodevelopmental morbidity at 1 year of age following extremely preterm delivery over a 20‐year period: a single centre cohort study. Acta Paediatrica 2008;97(2):159‐65. [PUBMED: 18254905] - PubMed
Singer 1999
    1. Singer LT, Salvator A, Guo S, Collin M, Lilien L, Baley J. Maternal psychological distress and parenting stress after the birth of a very low‐birth‐weight infant. JAMA 1999;281(9):799‐805. [PUBMED: 10071000] - PMC - PubMed
Slattery 2002
    1. Slattery MM, Morrison JJ. Preterm delivery. Lancet 2002;360(9344):1489‐97. [PUBMED: 12433531] - PubMed
Sosa 2015
    1. Sosa CG, Althabe F, Belizán JM, Bergel E. Bed rest in singleton pregnancies for preventing preterm birth. Cochrane Database of Systematic Reviews 2015, Issue 3. [DOI: 10.1002/14651858.CD003581.pub3] - DOI - PMC - PubMed
Stahl 2003
    1. Stahl K, Hundley V. Risk and risk assessment in pregnancy ‐ do we scare because we care?. Midwifery 2003;19(4):298‐309. - PubMed
Stevens 2007
    1. Stevens TP, Blennow M, Myers EH, Soll R. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD003063] - DOI - PMC - PubMed
Stevens‐Simon 1999
    1. Stevens‐Simon C, Orleans M. Low‐birthweight prevention programs: the enigma of failure. Birth (Berkeley, Calif.) 1999;26(3):184‐91. [PUBMED: 10655819] - PubMed
Tracy 2007
    1. Tracy SK, Tracy MB, Dean J, Laws P, Sullivan E. Spontaneous preterm birth of liveborn infants in women at low risk in Australia over 10 years: a population‐based study. BJOG :an international journal of obstetrics and gynaecology 2007;114(6):731‐5. [PUBMED: 17516965] - PubMed
Tsourapas 2009
    1. Tsourapas A, Roberts TE, Barton PM, Honest H, Forbes C, Hyde CJ, et al. An economic evaluation of alternative test‐intervention strategies to prevent spontaneous pre‐term birth in singleton pregnancies. Acta Obstetricia et Gynecologica Scandinavica 2009;88(12):1319‐30. [PUBMED: 19943821] - PubMed
Tucker 2004
    1. Tucker J, McGuire W. Epidemiology of preterm birth. BMJ (Clinical research ed.) 2004;329(7467):675‐8. [PUBMED: 15374920] - PMC - PubMed
Wilson 1968
    1. Wilson JMG, Jungner G. Principles and practice of screening for disease. Geneva: WHO, 1968. - PubMed
Wood 2005
    1. Wood NS, Costeloe K, Gibson AT, Hennessy EM, Marlow N, Wilkinson AR. The EPICure study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth. Archives of Disease in Childhood. Fetal and Neonatal Edition 2005;90(2):F134‐F140. [PUBMED: 15724037] - PMC - PubMed

References to other published versions of this review

Davey 2011
    1. Davey MA, Watson L, Rayner JA, Rowlands S. Risk scoring systems for predicting preterm birth with the aim of reducing associated adverse outcomes. Cochrane Database of Systematic Reviews 2011, Issue 11. [DOI: 10.1002/14651858.CD004902.pub4] - DOI - PubMed

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