The possibilities of predicting late premature spontaneous births

Z. V. Zyukina; S. V. Apresyan; E. V. Loginova; l. B. Tamazova

doi:10.21518/ms2025-546

The possibilities of predicting late premature spontaneous births

Z. V. Zyukina, S. V. Apresyan, E. V. Loginova, l. B. Tamazova

https://doi.org/10.21518/ms2025-546

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Abstract

Introduction. Late preterm spontaneous births (LPSB) constitute up to 75% of all preterm deliveries. However, current screening algorithms, demonstrate critically low sensitivity for predicting this specific subgroup, leaving most at-risk pregnancies undetected.

Aim. To develop and evaluate a prognostic model for LPSB based on a pathophysiologically grounded grouping of risk factors, incorporating cervical length measurement during second-trimester ultrasound screening.

Materials and methods. A retrospective analysis of 250 pregnant women (125 with LPSB, 125 with term births). Four predictors were assessed: adverse obstetric-gynecological history (AOGH), structural defects of the cervix (SDC), infectious-inflammatory conditions (IIC), and cervical canal length (CCL) measured transvaginally at 180–2066 weeks. The model was constructed using binary logistic regression. Predictive performance was evaluated via ROC analysis, sensitivity, specificity, and Youden’s index.

Results. Independent predictors of LPSB included: IIC (aOR = 28.284; p < 0.001), SDC (aOR = 3.320; p = 0.016), and CCL (aOR = 0.648 per 1 mm increase; p < 0.001). AOGH lost statistical significance in the multivariate model (p = 0.949). The model achieved an AUC of 0.956; at a cutoff of 0.563, both sensitivity and specificity reached 91.2%.

Conclusions. The proposed model enables highly accurate prediction of LPSB as early as the second trimester, significantly outperforming existing clinical tools. An integrated online calculator facilitates implementation into routine antenatal care, promoting timely preventive interventions and reducing neonatal morbidity risks.

Keywords

late preterm birth, prediction model, cervical length, infectious-inflammatory conditions, logistic regression, cervicometry, online calculator, preterm delivery, second trimester, perinatal outcomes

About the Authors

Z. V. Zyukina

Peoples’ Friendship University of Russia named after Patrice Lumum
Russian Federation

Zoya V. Zyukina, Postgraduate Student of the Department of Obstetrics, Gynecology and Perinatology, Medical Institute

6, Miklukho-Maklai St., Moscow, 11719

S. V. Apresyan

Peoples’ Friendship University of Russia named after Patrice Lumumba; City Clinical Hospital named after A.K. Eramishantsev
Russian Federation

Sergey V. Apresyan, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Obstetrics and Gynecology with a Course in Perinatology, Medical Institute, Peoples’ Friendship University of Russia named after Patrice Lumumba; Deputy Chief Physician for Obstetric and Gynecological Care, City Clinical Hospital named after A.K. Eramishantsev

6, Miklukho-Maklai St., Moscow, 117198,

15, Lenskaya St., Moscow, 129327

E. V. Loginova

Peoples’ Friendship University of Russia named after Patrice Lumum
Russian Federation

Ekaterina V. Loginova, Cand. Sci. (Med.), Assistant Professor, Department of Obstetrics, Gynecology and Perinatology, Medical Institute

6, Miklukho-Maklai St., Moscow, 11719

l. B. Tamazova

Peoples’ Friendship University of Russia named after Patrice Lumum
Russian Federation

Lyana B. Tamazova, Postgraduate Student of the Department of Obstetrics, Gynecology and Perinatology, Medical Institute

6, Miklukho-Maklai St., Moscow, 11719

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For citations:

Zyukina ZV, Apresyan SV, Loginova EV, Tamazova lB. The possibilities of predicting late premature spontaneous births. Meditsinskiy sovet = Medical Council. 2025;(23):160-167. (In Russ.) https://doi.org/10.21518/ms2025-546

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