Fetal fibronectin detection for prediction of preterm birth in low risk women.
OBJECTIVE
To evaluate the clinical value of cervical fetal fibronectin detection by a quantitative enzyme-linked immunosorbent assay (ELISA) (PTDcheck, Adeza Biomedical, Sunnyvale, California, USA) as a screening tool for the prediction of preterm contractions and preterm delivery in an unselected population of pregnant women globally considered to be at low risk for preterm delivery (n = 133).


METHODS
A prospective study in which cervical fetal fibronectin samples were collected at two-week intervals between 26 and 36 weeks of gestation.


METHODS
A regional training hospital.


METHODS
One hundred and thirty-three singleton pregnancies presenting consecutively at an antenatal clinic.


METHODS
Occurrence of preterm contractions and preterm delivery (delivery at < 37 weeks of gestation).


RESULTS
Twenty-four (18%) patients were considered positive for the presence of fetal fibronectin. Overall 15 patients (11%) developed preterm contractions and, despite therapeutic intervention, 10 patients (8%) were delivered preterm. As a predictor for preterm contractions, cervical fetal fibronectin detection had a sensitivity of 47%, a specificity of 86%, a positive predictive value of 29% and a negative predictive value of 93%. As a predictor for preterm delivery, cervical fetal fibronectin detection had a sensitivity of 60%, a specificity of 85% a positive predictive value of 25% and a negative predictive value of 96%.


CONCLUSIONS
Cervical fetal fibronectin determinations at a two-week sampling frequency for prediction of preterm birth in a general obstetric population at low risk for preterm birth has limited clinical value as a routinely performed screening procedure.
Hellemans
P
P
Department of Obstetrics, Gynaecology, General Hospital Middelheim, Antwerp, Belgium.
Gerris
J
J
Verdonk
P
P
D000328:Adult; D002584:Cervix Uteri / Q000737:chemistry*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D005353:Fibronectins