{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:12:58Z","timestamp":1793686378761,"version":"4.5.1"},"reference-count":43,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sera Prognostics, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The AVERT PRETERM trial (NCT03151330) evaluated whether screening clinically low-risk pregnancies with a validated maternal blood biomarker test for spontaneous preterm birth (sPTB) risk, followed by preventive treatments for those screening positive, would improve neonatal outcomes compared to a clinically low-risk historical population that had received the usual care. Prospective arm participants with singleton non-anomalous pregnancies and no PTB history were tested for sPTB risk at 191\/7\u2013206\/7 weeks\u2019 gestation and followed up with after neonatal discharge. Screen-positive individuals (\u226516% sPTB risk) were offered vaginal progesterone (200 mg) and aspirin (81 mg) daily, with twice-weekly nurse phone calls. Co-primary outcomes were neonatal morbidity and mortality, measured using a validated composite index (NMI), and neonatal hospital length of stay (NNLOS). Endpoints were assessed using survival analysis and logistic regression in a modified intent-to-treat population comprising screen-negative individuals and screen-positive individuals accepting treatment. Of 1460 eligible participants, 34.7% screened positive; of these, 56.4% accepted interventions and 43.6% declined. Compared to historical controls, prospective arm neonates comprising mothers accepting treatment had lower NMI scores (odds ratio 0.81, 95% CI, 0.67\u20130.98, p = 0.03) and an 18% reduction in severe morbidity. NNLOS was shorter (hazard ratio 0.73, 95% CI, 0.58\u20130.92, p = 0.01), with a 21% mean stay decrease among neonates having the longest stays. Sensitivity analyses in the entire intent-to-treat population supported these findings. These results suggest that biomarker sPTB risk stratification and preventive interventions can ameliorate PTB complications in singleton, often nulliparous, pregnancies historically deemed low risk.<\/jats:p>","DOI":"10.3390\/diagnostics14141462","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T07:16:07Z","timestamp":1720509367000},"page":"1462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Neonatal Outcomes after Maternal Biomarker-Guided Preterm Birth Intervention: The AVERT PRETERM Trial"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2927-8693","authenticated-orcid":false,"given":"Matthew K.","family":"Hoffman","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, ChristianaCare, Newark, DE 19718, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Kitto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, ChristianaCare, Newark, DE 19718, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zugui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, ChristianaCare, Newark, DE 19718, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Shi","sequence":"additional","affiliation":[{"name":"Walker Bioscience, Carlsbad, CA 92009, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2677-794X","authenticated-orcid":false,"given":"Michael G.","family":"Walker","sequence":"additional","affiliation":[{"name":"Walker Bioscience, Carlsbad, CA 92009, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Shahbaba","sequence":"additional","affiliation":[{"name":"Departments of Statistics and Computer Science, University of California Irvine, Irvine, CA 92697, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Ruhstaller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, ChristianaCare, Newark, DE 19718, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1016\/S0140-6736(16)31593-8","article-title":"Global, regional, and national causes of under-5 mortality in 2000-15: An updated systematic analysis with implications for the Sustainable Development Goals","volume":"388","author":"Liu","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Martin, J.A., Hamilton, B.E., and Osterman, M.J.K. 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