title: Combined fetal fibronectin and cervical length and spontaneous preterm birth in asymptomatic triplet pregnancies.
abstract: OBJECTIVE
  To estimate the association between fetal fibronectin (fFN), cervical length (CL), and spontaneous preterm birth (SPTB) in asymptomatic women with triplet pregnancies.
  
  
  METHODS
  A cohort of 39 consecutive women with triplet pregnancies managed in one Maternal-Fetal medicine practice from 2005-2011 was analyzed. Combined fFN and CL testing was performed every 2 weeks from 22-32 weeks. A short CL was defined as ≤ 20 mm.
  
  
  RESULTS
  A positive fFN was significantly associated with SPTB <28 weeks, <30 weeks, <32 weeks, and <34 weeks. A short CL was significantly associated with SPTB <32 weeks. On combined testing, having both tests positive was associated with the highest likelihood of SPTB at all gestational ages. As a screening test for SPTB <32 weeks, having both a positive fFN and a short CL had a sensitivity of 62.5%, specificity of 90%, positive predictive value of 62.5%, negative predictive value of 90%, positive likelihood ration of 2.98 and negative likelihood ratio of 0.88. Combined fFN and CL outperformed fFN alone, CL alone, or either test being positive alone.
  
  
  CONCLUSIONS
  In asymptomatic women with triplet pregnancies, fFN and CL are each significantly associated with SPTB. For the prediction of SPTB, combined fFN and CL testing outperforms either test alone.
authors.affiliation: Maternal Fetal Medicine Associates, PLLC, New York, NY 10128, USA. nfox@mfmnyc.com
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Fox
authors.forename: Andrei
authors.initials: A
authors.lastname: Rebarber
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Roman
authors.forename: Chad K
authors.initials: CK
authors.lastname: Klauser
authors.forename: Danielle
authors.initials: D
authors.lastname: Peress
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Saltzman
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002584:Cervix Uteri / Q000033:anatomy & histology* / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005333:Fetus / Q000378:metabolism*; D005353:Fibronectins / Q000032:analysis / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000378:metabolism / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000378:metabolism / Q000502:physiology; D059286:Pregnancy, Triplet / Q000378:metabolism* / Q000502:physiology; D047928:Premature Birth / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D011296:Prenatal Diagnosis / Q000379:methods; D055815:Young Adult
chemical_list: D005353:Fibronectins