Document Detail

Risk scoring, fetal fibronectin, and bacterial vaginosis to predict preterm delivery.
MedLine Citation:
PMID:  10214825     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the value of markers for predicting spontaneous preterm birth. METHODS: One hundred forty asymptomatic gravidas were recruited from 20-24 weeks' gestation. Risk score was assessed, vaginal swabs were analyzed for bacterial vaginosis, and cervical and vaginal swab were tested for fetal fibronectin FDC-6, X18A4, and CAF. Univariate analysis was used to determine potential predictors (and combinations of predictors) of outcome. Multiple logistic regression was done to identify independent predictors of spontaneous preterm birth. Sensitivity, specificity, positive and negative predictive values; and odds and likelihood ratios were calculated for significant predictors. RESULTS: Predictors significantly associated with the primary outcome were preterm birth-risk score and vaginal fetal fibronection FDC-6 (logistic regression odds ratio [OR] 16.9 [95% confidence interval (CI) 3.1, 92.8]) and 8.0 ([95% CI 1.6, 38.2], respectively). Bacterial vaginosis, fetal fibronectin X18A4, fibronectin CAF, and cervical fetal fibronectin FDC-6 were not associated with spontaneous preterm birth; however, the statistical power to assess these variables was limited. The combination of positive preterm birth-risk score and vaginal fetal fibronectin FDC-6 had a sensitivity of 44.4%, specificity of 97.7%, positive predictive value of 57.1%, negative predictive value of 96.2%, and a significant likelihood ratio for a positive test of 19.4 (95% CI 5.1, 73.8). CONCLUSION: The combination of preterm birth-risk score and vaginal fetal fibronectin FDC-6 predicted spontaneous preterm birth. Intervention trials are required to determine whether a combination of screening tests will reduce rates of spontaneous preterm birth.
J M Crane; B A Armson; L Dodds; R F Feinberg; W Kennedy; S A Kirkland
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  93     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-20     Completed Date:  1999-05-20     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  517-22     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John's, Canada.
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MeSH Terms
Cervix Uteri / chemistry
Fibronectins / analysis*
Obstetric Labor, Premature / complications,  diagnosis*
Predictive Value of Tests
Regression Analysis
Sensitivity and Specificity
Vagina / chemistry
Vaginosis, Bacterial / complications*
Reg. No./Substance:

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