Fetal fibronectin in vaginal specimens predicts preterm delivery and very-low-birth-weight infants.
OBJECTIVE
The purpose of this study was to evaluate the association of vaginal fetal fibronectin expression to risk of preterm delivery and delivery of very-low-birth-weight infants.


METHODS
Vaginal secretions were obtained from women between 22 and 35 weeks' pregnant with minimal cervical dilation (< or = 2 cm) and threatened preterm delivery. The secretions were analyzed for the presence of fetal fibronectin. Other clinical information including cervical dimensions, uterine activity, serum C-reactive protein concentration, vaginal pH, evidence of vaginal or systemic infection, and vaginal bleeding were also obtained.


RESULTS
Of the 112 patients recruited, 40 (35.7%) were delivered prematurely (<37 weeks). For prediction of preterm delivery, the fetal fibronectin test result had a sensitivity, specificity, and positive and negative predictive values of 67.5, 90.3, 79.4, and 83.3%, respectively (odds ratio 19.3, p < 0.0001). Women with a positive fetal fibronectin test had a nearly 13-fold increased probability of being delivered of an infant weighing <1500 gm than did women with a negative fetal fibronectin test (32.4% vs 2.5%, p<0.0001). Categoric analysis and multiple logistic regression demonstrated that fetal fibronectin was an independent risk factor for prediction of preterm delivery and birth weight <1500 gm.


CONCLUSIONS
Vaginal fetal fibronectin expression is an independent risk factor for preterm delivery and birth of very-low-birth-weight infants in symptomatic women with intact amniotic membranes and minimal cervical dilatation.
Bartnicki
J
J
Institute of Perinatal Medicine, Berlin-Neukölln, Germany.
Casal
D
D
Kreaden
U S
US
Saling
E
E
Vetter
K
K
D016009:Chi-Square Distribution; D005260:Female; D005333:Fetus / Q000378:metabolism*; D005353:Fibronectins / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000378:metabolism; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014621:Vagina / Q000378:metabolism*
D005353:Fibronectins