Multivariable prediction of preterm birth in multiple pregnancy
A pathogenetically grounded approach to prediction of preterm birth, weighted assessment and risk management are nowadays the key determinants of a favourable outcome of multiple pregnancies. In this connection, specification of predictors permitting to stratify the risks of preterm birth in a multiple pregnancy, is a very important task. Objective. Search for and study of the predictors of preterm birth in multiple pregnancy. Patients and methods. For the purposes of identification of factors and comprehensive assessment of the cumulative risk of preterm birth, statistical analysis of pregnancy and labour was conducted in 452 patients with dichorial twins. Results. The main risk factors that are reliably associated with the development of spontaneous preterm labour in multiple pregnancies are: being more than 32 years of age, pregnancy following IVF, reproductive losses, inflammatory pelvic diseases, hereditary thrombophilia, threatened abortion, persistence of Enterococcus faecalis in the cervical canal. The use of modern statistical methods did not allow singling out «weak » or «strong » factors from the above. Each of them makes an equal contribution to the occurrence of preterm birth in a multiple pregnancy. Conclusion. Identification of the established risk factors is helpful for distributing patients with multiple pregnancy to different risk groups of preterm birth, which makes it possible to choose successful strategies in order to prolong a multiple.