Prospective evaluation of a risk scoring system for predicting preterm delivery in black inner city women
Main, D.M.; Richardson, D.; Gabbe, S.G.; Strong, S.; Weller, S.C.
Obstetrics and Gynecology 69(1): 61-66
1987
ISSN/ISBN: 0029-7844 PMID: 3796921 Document Number: 297139
Nine percent of United States births are preterm. The ability to efficiently identify women destined to deliver before term would enable obstetricians to initiate early intervention. The Papiernik-Creasy risk scoring system is being extensively applied for this purpose, without prospective validation in this country. We evaluated prospectively its ability to predict high risk women in a black inner city population, when applied once early in pregnancy. The system, based on social, past medical, and current pregnancy problems, failed to identify at-risk patients. Adjusting the score cut/off and reweighting factors with discriminate analysis did not improve the predictive value. Analysis of an additional 60 social, demographic, and medical factors failed to produce a useful alternative risk assessment tool. We suggested that risk scoring systems such as these may not be helpful in socioeconomically at-risk populations.