title: Prediction of preterm delivery by fetal fibronectin in symptomatic and asymptomatic women with cervical length ≤20 mm.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of cervicovaginal fetal fibronectin (fFN) in predicting preterm delivery (PTD) in symptomatic and asymptomatic women with cervical length (CL) ≤ 20 mm.
  
  
  METHODS
  A retrospective cohort study on pregnant singleton women admitted for CL ≤ 20 mm, with or without uterine contractions, between 22 and 34 weeks. For each group, symptomatic and asymptomatic, the following outcomes were evaluated: PTD before 37 and 34 weeks, delivery within 48 h, 7, 14 and 21 days after fibronectin sampling.
  
  
  RESULTS
  128 women admitted for CL ≤ 20 mm were identified. Of these, 43 had uterine contractions, while 85 were asymptomatic. A positive fFN test was detected in 33% of symptomatic patients and it was significantly associated with PTD < 37 and 34 weeks and within 48 hours, 7, 14 and 21 days from admission (p < 0.05). After logistic regression analysis, fFN remained an independent predictor for all outcomes. In the asymptomatic group fFN test was positive only in 6% of patients, and a positive result was not significantly associated with any of the outcomes.
  
  
  CONCLUSIONS
  In women with contractions and CL ≤ 20 mm, fFN is an effective marker of PTD. Sensitivity and specificity rates for PTD within 7-14 days are higher than those reported in studies including women with CL > 20 mm. In asymptomatic women, fFN appeared not as effective in predicting PTD.
authors.affiliation: a Maternal and Child Department, Careggi University Hospital Florence , Florence , Italy and.
authors.forename: Elena
authors.initials: E
authors.lastname: Magro-Malosso
authors.affiliation: b Department of Gynecology and Obstetrics , Center for Fetal Therapy, The Johns Hopkins Hospital , Baltimore , MD , USA.
authors.forename: Viola
authors.initials: V
authors.lastname: Seravalli
authors.affiliation: a Maternal and Child Department, Careggi University Hospital Florence , Florence , Italy and.
authors.forename: Mauro
authors.initials: M
authors.lastname: Cozzolino
authors.affiliation: a Maternal and Child Department, Careggi University Hospital Florence , Florence , Italy and.
authors.forename: Marina
authors.initials: M
authors.lastname: Spitaleri
authors.affiliation: a Maternal and Child Department, Careggi University Hospital Florence , Florence , Italy and.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Susini
authors.affiliation: a Maternal and Child Department, Careggi University Hospital Florence , Florence , Italy and.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Di Tommaso
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000378:metabolism; D054791:Cervical Length Measurement; D005260:Female; D005353:Fibronectins / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; C403421:FFN protein, human; D005353:Fibronectins
keywords: Cervical length; fibronectin; preterm delivery