title: Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length.
abstract: OBJECTIVE
  The purpose of this study was to evaluate combined fetal fibronectin (fFN) test result and cervical length (CL) as predictors of spontaneous preterm birth in asymptomatic twin pregnancies.
  
  
  METHODS
  We examined a retrospective cohort of 155 twin pregnancies with combined fFN and CL testing between 22 and 32 weeks gestation.
  
  
  RESULTS
  A positive fFN test result at 22-32 weeks or a CL <20 mm increased the risk of spontaneous preterm birth at <37, <34, <32, <30, and <28 weeks' gestation. The combination of a positive fFN test result and CL<20 mm had a significantly higher positive predictive value for delivery at all gestational ages than either positive test alone. On adjusted analysis, a positive fFN test result was a stronger predictor of spontaneous preterm birth than a short CL.
  
  
  CONCLUSIONS
  In asymptomatic twin pregnancies, fFN and CL testing between 22 and 32 weeks gestation can identify pregnancies that are at significantly increased risk for preterm birth, including deliveries at <28 weeks' gestation.
authors.affiliation: Maternal Fetal Medicine Associates, PLLC, New York, NY 10128, USA.
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Fox
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Saltzman
authors.forename: Chad K
authors.initials: CK
authors.lastname: Klauser
authors.forename: Danielle
authors.initials: D
authors.lastname: Peress
authors.forename: Christina V
authors.initials: CV
authors.lastname: Gutierrez
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000453:epidemiology*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal
chemical_list: D005353:Fibronectins