title: The prediction of preeclampsia: reassessment of clinical value of increased plasma levels of fibronectin.
abstract: OBJECTIVE
  To determine whether assessment of plasma fibronectin in primigravidae could predict the pregnant women expected to become preeclamptic.
  
  
  METHODS
  We performed a prospective blinded analysis of 156 apparently normotensive primigravidae in an outpatient clinic. Blood samples were taken at 6 week intervals from the 18th week and immediately after delivery or at the onset of preeclampsia. Plasma fibronectin was evaluated by ELISA. Evolution with gestational age was studied using regression curves.
  
  
  RESULTS
  We had 148 normal primigravidae (592 determinations). In three women, increased fibronectin anticipated preeclampsia by 3-4 weeks. Five women showed high levels only at the onset of preeclampsia. Sensitivity, specificity, positive and negative predictive values of increased fibronectin levels were 37.5% (95% CI=3.3-71.7), 96.6% (95% CI=93.7-99.6), 37.5% (95% CI=3.3-71.7) and 96.6% (95% CI=93.7-99.6), respectively.
  
  
  CONCLUSIONS
  This study shows that plasma fibronectin levels could represent a specific marker for preeclampsia. Its sensitivity has to be improved but its high negative predictive value strongly argues against the development of preeclampsia within the next 4 weeks after the blood sampling.
authors.affiliation: Department of Obstetrics and Gynecology, Hôpitaux Universitaires de Strasbourg, Hôpital Hautepierre, France.
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
authors.forename: J J
authors.initials: JJ
authors.lastname: Baldauf
authors.forename: J
authors.initials: J
authors.lastname: Ritter
authors.forename: J R
authors.initials: JR
authors.lastname: Van Cauwenberg
authors.forename: A
authors.initials: A
authors.lastname: Hardy
authors.forename: J M
authors.initials: JM
authors.lastname: Foidart
mesh_terms: D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005353:Fibronectins / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis*; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D005353:Fibronectins