title: Comparison of the Actim Partus test and the fetal fibronectin test in the prediction of spontaneous preterm birth in symptomatic women undergoing cervical length measurement.
abstract: OBJECTIVE
  To compare the accuracy of the Actim Partus test and fetal fibronectin (fFN) test in the prediction of spontaneous preterm delivery within seven days in symptomatic women undergoing cervical length measurement.
  
  
  METHODS
  We performed a post-hoc analysis on frozen samples of a nationwide cohort study in all 10 perinatal centres in the Netherlands. We selected samples from women with signs of preterm labour between 24 and 34 weeks of gestational age and a cervical length below 30mm. Delivery within seven days after initial assessment was the primary endpoint. We calculated sensitivity, specificity, and positive and negative predictive values for the combination of both the Actim Partus test and fFN test with cervical length. A test was considered positive in case of a cervical length between 15 and 30mm with a positive Actim Partus or fFN test, and a cervical length below 15mm regardless the test result.
  
  
  RESULTS
  In total, samples of 350 women were tested, of whom 69 (20%) delivered within seven days. Eighty-four women had a positive Actim Partus test and 162 women a positive fFN test, of whom 54 (64%) and 63 (39%) delivered within seven days, respectively. Ninety-seven women had a cervical length below 15mm, of whom 50 (52%) delivered within seven days. Sensitivity, specificity, positive and negative predictive values of combining cervical length with the Actim Partus test or the fFN test were 91%, 75%, 47% and 97%, and 96%, 58%, 36% and 98%, respectively.
  
  
  CONCLUSIONS
  According to this post-hoc study, in combination with cervical length, the Actim Partus test could be used as an alternative for the fFN test to identify women who will not deliver within seven days after presentation. Further evidence should be collected in a prospective comparative study.
authors.affiliation: Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, Netherlands. Electronic address: m.m.bruijn@amc.uva.nl.
authors.forename: Merel M C
authors.initials: MM
authors.lastname: Bruijn
authors.affiliation: Clinical Chemistry and Haematology, University Medical Centre Utrecht, Netherlands.
authors.forename: Jolande Y
authors.initials: JY
authors.lastname: Vis
authors.affiliation: Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands.
authors.forename: Femke F
authors.initials: FF
authors.lastname: Wilms
authors.affiliation: Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, Netherlands; Obstetrics and Gynaecology, University Medical Centre Utrecht, Utrecht, Netherlands.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Oudijk
authors.affiliation: Obstetrics and Gynaecology, University Medical Centre Utrecht, Utrecht, Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Kwee
authors.affiliation: Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands.
authors.forename: Martina M
authors.initials: MM
authors.lastname: Porath
authors.affiliation: Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands.
authors.forename: Guid
authors.initials: G
authors.lastname: Oei
authors.affiliation: Obstetrics and Gynaecology, University Hospital Maastricht, Maastricht, Netherlands.
authors.forename: Hubertina C J
authors.initials: HC
authors.lastname: Scheepers
authors.affiliation: Obstetrics and Gynaecology, University Hospital Maastricht, Maastricht, Netherlands.
authors.forename: Marc E A
authors.initials: ME
authors.lastname: Spaanderman
authors.affiliation: Obstetrics, Leiden University Medical Centre, Leiden, Netherlands.
authors.forename: Kitty W M
authors.initials: KW
authors.lastname: Bloemenkamp
authors.affiliation: Obstetrics, Leiden University Medical Centre, Leiden, Netherlands.
authors.forename: Monique C
authors.initials: MC
authors.lastname: Haak
authors.affiliation: Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, Netherlands.
authors.forename: Antoinette C
authors.initials: AC
authors.lastname: Bolte
authors.affiliation: Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, Netherlands.
authors.forename: Frank P H A
authors.initials: FP
authors.lastname: Vandenbussche
authors.affiliation: Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, Netherlands.
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Woiski
authors.affiliation: Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, Netherlands.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Bax
authors.affiliation: Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, Netherlands.
authors.forename: Jérôme M J
authors.initials: JM
authors.lastname: Cornette
authors.affiliation: Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, Netherlands.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Duvekot
authors.affiliation: Obstetrics and Gynaecology, Isala Clinics, Zwolle, Netherlands.
authors.forename: Bas W A
authors.initials: BW
authors.lastname: Nij Bijvank
authors.affiliation: Obstetrics and Gynaecology, Isala Clinics, Zwolle, Netherlands.
authors.forename: Jim
authors.initials: J
authors.lastname: van Eyck
authors.affiliation: Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, Netherlands.
authors.forename: Maureen T M
authors.initials: MT
authors.lastname: Franssen
authors.affiliation: Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, Netherlands.
authors.forename: Krystyna M
authors.initials: KM
authors.lastname: Sollie
authors.affiliation: Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Joris A M
authors.initials: JA
authors.lastname: van der Post
authors.affiliation: Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Patrick M M
authors.initials: PM
authors.lastname: Bossuyt
authors.affiliation: Clinical Research Unit, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.affiliation: Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Kok
authors.affiliation: The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia.
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: van Baaren
mesh_terms: D000328:Adult; D054791:Cervical Length Measurement; D002584:Cervix Uteri; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D005353:Fibronectins
keywords: Actim Partus; Cervical length; Diagnostic accuracy; Fetal fibronectin; Prediction; Preterm birth