Document Detail


Clinical utility of fetal fibronectin for predicting preterm birth.
MedLine Citation:
PMID:  16419634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if fetal fibronectin can be used in a clinical setting to predict preterm birth and guide clinical management. STUDY DESIGN: We implemented a clinical protocol using the rapid fetal fibronectin test for patients presenting with symptoms of preterm labor. Adherence to the clinical pathway was at the discretion of the practitioner. Subjects who met the inclusion criteria (n = 404) were divided into 2 groups based on the fetal fibronectin result. Outcomes included time until delivery, gestational age at delivery and use of therapeutic interventions. Univariate and multivariate statistical analyses were performed. RESULTS: The 46 subjects (11.4%) with positive fetal fibronectin were more likely to deliver within 7 days, within 14 days, prior to 32 weeks' gestation and prior to 37 weeks' gestation (RR 22.0, 22.0, 12.3 and 5.1, respectively). For delivery within 7 days, the sensitivity, specificity, positive predictive value and negative predictive value were 67%, 92%, 30% and 98%, respectively. Time until delivery and gestational age at delivery were lower in women with a positive test, while the frequency of therapeutic interventions was higher (p < 0.01). CONCLUSION: A positive fetal fibronectin test is predictive of preterm birth in a clinical setting. A negative fetal fibronectin test can be used to avoid unnecessary, potentially harmful interventions.
Authors:
Geeta K Swamy; Hyagriv N Simhan; Hilary S Gammill; R Phillips Heine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  50     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-01-19     Completed Date:  2006-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Duke University School of Medicine, Durham, North Carolina, USA. swamy002@mc.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / analysis
Cohort Studies
Female
Fetal Proteins / analysis*,  diagnostic use
Fibronectins / analysis*,  diagnostic use
Forecasting
Gestational Age
Humans
Infant, Newborn
Multivariate Analysis
Obstetric Labor, Premature / diagnosis*
Predictive Value of Tests
Pregnancy
Prospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fetal Proteins; 0/Fibronectins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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