The impact of fetal fibronectin testing for women with symptoms of preterm labour in routine clinical practice within a New Zealand population.
OBJECTIVE
To perform a comparative analysis of antenatal management received according to the results of cervico-vaginal fetal fibronectin (fFN) testing, and to review preterm delivery rates and fFN predictive values within a New Zealand population of women presenting with threatened preterm labour.


METHODS
Case note review of all fFN tests performed at Middlemore Hospital, South Auckland from August 2003 to March 2005 (n = 199). Data collected included risk factors for preterm delivery, signs and symptoms at presentation, antenatal management received after fFN test and outcome and delivery details. Positive and negative fFN results were compared.


RESULTS
Women with a positive fFN were more likely to receive antenatal corticosteroids (96.4 vs 4.7% RR 8.74 (95% CI 5.40-14.17)) and tocolysis (71.4 vs 2.4% RR 8.10 (95% CI 4.49-14.59)) and to be admitted antenatally (96.4 vs 54.4% RR 1.77 (95% CI 1.50-2.10)) with a higher mean cost of treatment (967.47 NZ dollars vs 335.27 NZ dollars P < 0.05). Rates of delivery < 34 weeks were higher in those with a positive fFN (41.9 vs 0.7% RR 62.06 (95% CI 8.43-457.14)).


CONCLUSIONS
Women with a positive fFN result received different treatment to those with a negative fFN. Use of fFN test in routine clinical practice allows management and resources to be targeted more appropriately and may limit unnecessary interventions.
Groom
Katie M
KM
Department of Obstetrics and Gynaecology, Middlemore Hospital, Hospital Road, Otahuhu, Auckland, New Zealand. katiegroom@xtra.co.nz
Liu
Emily
E
Allenby
Keith
K
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D005260:Female; D005353:Fibronectins / Q000097:blood*; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000175:diagnosis / Q000191:economics; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control; D011295:Prenatal Care / Q000191:economics; D012189:Retrospective Studies; D012307:Risk Factors; D015145:Tocolysis / Q000706:statistics & numerical data; D019564:Unnecessary Procedures / Q000191:economics
D000305:Adrenal Cortex Hormones; D005353:Fibronectins