title: Predictive value of cervical length measurement and fibronectin testing in threatened preterm labor.
abstract: OBJECTIVE
  To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor.
  
  
  METHODS
  We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk.
  
  
  RESULTS
  Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk.
  
  
  CONCLUSIONS
  Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.
  
  
  METHODS
  II.
authors.affiliation: Departments of Obstetrics and Gynecology, Academic Medical Center and VU University Medical Center, Amsterdam, University Medical Center Utrecht, Utrecht, Maastricht University Medical Center, Maastricht, Máxima Medical Center, Veldhoven, Erasmus Medical Center, Rotterdam, Isala Clinics, Zwolle, University Medical Center Groningen, Groningen, Leiden University Medical Center, and Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands, Northwestern University Medical School, Chicago, Illinois, and The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia; Clinical Epidemiology, Biostatistics and Bioinformatics and the Clinical Research Unit, Academic Medical Center, Amsterdam, and the Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: van Baaren
authors.forename: Jolande Y
authors.initials: JY
authors.lastname: Vis
authors.forename: Femke F
authors.initials: FF
authors.lastname: Wilms
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Oudijk
authors.forename: Anneke
authors.initials: A
authors.lastname: Kwee
authors.forename: Martina M
authors.initials: MM
authors.lastname: Porath
authors.forename: Guid
authors.initials: G
authors.lastname: Oei
authors.forename: Hubertina C J
authors.initials: HCJ
authors.lastname: Scheepers
authors.forename: Marc E A
authors.initials: MEA
authors.lastname: Spaanderman
authors.forename: Kitty W M
authors.initials: KWM
authors.lastname: Bloemenkamp
authors.forename: Monique C
authors.initials: MC
authors.lastname: Haak
authors.forename: Antoinette C
authors.initials: AC
authors.lastname: Bolte
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Bax
authors.forename: Jérôme M J
authors.initials: JMJ
authors.lastname: Cornette
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Duvekot
authors.forename: Bas W A
authors.initials: BWA
authors.lastname: Nij Bijvanck
authors.forename: Jim
authors.initials: J
authors.lastname: van Eyck
authors.forename: Maureen T M
authors.initials: MTM
authors.lastname: Franssen
authors.forename: Krystyna M
authors.initials: KM
authors.lastname: Sollie
authors.forename: Frank P H A
authors.initials: FPHA
authors.lastname: Vandenbussche
authors.forename: Mallory
authors.initials: M
authors.lastname: Woiski
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.forename: Joris A M
authors.initials: JAM
authors.lastname: van der Post
authors.forename: Patrick M M
authors.initials: PMM
authors.lastname: Bossuyt
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.forename: Ben W J
authors.initials: BWJ
authors.lastname: Mol
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D005353:Fibronectins / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000473:pathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D005353:Fibronectins