Is routine infectious and toxicologic screening in preterm labor effective in predicting preterm birth?

OBJECTIVE: Our objective was to evaluate whether a significant association exists between cocaine use, cervical, urine, and/or Group B streptococcus (GBS) infections and preterm birth (PTB) in patients admitted with active preterm labor (PTL). STUDY DESIGN: A retrospective cohort study of PTL patients < 34 weeks (n = 400) admitted to a large, urban tertiary care hospital (2002-2005) was performed. Pertinent history and screening test results were collected. The prevalence of a positive result for each test was determined. Pearson chi-square and Poisson regression were used to evaluate the significance of associations between screening tests and PTB and to control for confounders. RESULTS: The percentage of patients that delivered at < 37 and < 34 weeks was 63.5% (n = 254) and 44.5% (n = 178), respectively. Only cocaine use was significantly associated with PTB at < 34 weeks (RR 1.86, 95%CI 1.03, 2.08). CONCLUSION: This laboratory test panel is not an effective adjunctive means to predict PTB in PTL patients.