Evaluation of a quantitative fetal fibronectin test for spontaneous preterm birth in symptomatic women

Danielle S. Abbott; Samara K. Radford; Paul T. Seed; Rachel M. Tribe; Andrew H. Shennan

doi:10.1016/j.ajog.2012.10.890

Evaluation of a quantitative fetal fibronectin test for spontaneous preterm birth in symptomatic women

Danielle S. Abbott^*, Samara K. Radford, Paul T. Seed, Rachel M. Tribe, Andrew H. Shennan

^*Corresponding author for this work

Women & Children's Health

St Thomas Hosp, Guy's & St Thomas' NHS Foundation Trust, University of London, Kings College London, Kings Hlth Partners, Womens Hlth Acad Ctr, Kings Coll London,Div Womens Hlth

Research output: Contribution to journal › Article › peer-review

109 Citations (Scopus)

Abstract

Objective
The purpose of this study was to determine whether quantification of cervicovaginal fluid fetal fibronectin (fFN) improves diagnostic accuracy of spontaneous preterm birth (sPTB) in symptomatic women.

Study Design
A prospective blinded predefined secondary analysis of a larger study of cervicovaginal fluid fFN concentration (nanograms per milliliter) in women symptomatic of preterm labor (n =300 women; 22-35 weeks' gestation) with a Hologic 10Q system (Hologic, Marlborough, MA). Clinicians were blinded to the result until after the delivery, but the qualitative Hologic TLIIQ fFN result was made available.

Results
The positive predictive value for sPTB (<34 weeks' gestation) increased from 19%, 32%, 61%, and 75% with increasing thresholds (10, 50, 200, and 500 ng/mL, respectively). Compared with <10 ng/mL fFN, the relative risk of delivery was 5.6 (95% confidence interval [CI], 1.05–29.57), 7.9 (95% CI, 1.38–45.0), 22.8 (95% CI, 3.84–135.5), and 51.3 (95% CI, 12.49–211.2; P < .01).

Conclusion
Quantitative fFN provides thresholds (10 and 200 ng/mL) in addition to the qualitative method (50 ng/mL) to discriminate the risk of sPTB in symptomatic women.

Original language	English
Article number	N/A
Pages (from-to)	122.e1-122.e6
Number of pages	6
Journal	American Journal of Obstetrics and Gynecology
Volume	208
Issue number	2
DOIs	https://doi.org/10.1016/j.ajog.2012.10.890
Publication status	Published - Feb 2013

Keywords

fetal fibronectin
preterm birth
RISK
PREDICTOR
ACCURACY
DELIVERY

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10.1016/j.ajog.2012.10.890

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title = "Evaluation of a quantitative fetal fibronectin test for spontaneous preterm birth in symptomatic women",

abstract = "ObjectiveThe purpose of this study was to determine whether quantification of cervicovaginal fluid fetal fibronectin (fFN) improves diagnostic accuracy of spontaneous preterm birth (sPTB) in symptomatic women.Study DesignA prospective blinded predefined secondary analysis of a larger study of cervicovaginal fluid fFN concentration (nanograms per milliliter) in women symptomatic of preterm labor (n =300 women; 22-35 weeks' gestation) with a Hologic 10Q system (Hologic, Marlborough, MA). Clinicians were blinded to the result until after the delivery, but the qualitative Hologic TLIIQ fFN result was made available.ResultsThe positive predictive value for sPTB (<34 weeks' gestation) increased from 19%, 32%, 61%, and 75% with increasing thresholds (10, 50, 200, and 500 ng/mL, respectively). Compared with <10 ng/mL fFN, the relative risk of delivery was 5.6 (95% confidence interval [CI], 1.05–29.57), 7.9 (95% CI, 1.38–45.0), 22.8 (95% CI, 3.84–135.5), and 51.3 (95% CI, 12.49–211.2; P < .01).ConclusionQuantitative fFN provides thresholds (10 and 200 ng/mL) in addition to the qualitative method (50 ng/mL) to discriminate the risk of sPTB in symptomatic women.",

keywords = "fetal fibronectin, preterm birth, RISK, PREDICTOR, ACCURACY, DELIVERY",

author = "Abbott, {Danielle S.} and Radford, {Samara K.} and Seed, {Paul T.} and Tribe, {Rachel M.} and Shennan, {Andrew H.}",

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doi = "10.1016/j.ajog.2012.10.890",

language = "English",

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AU - Abbott, Danielle S.

AU - Radford, Samara K.

AU - Seed, Paul T.

AU - Tribe, Rachel M.

AU - Shennan, Andrew H.

PY - 2013/2

Y1 - 2013/2

N2 - ObjectiveThe purpose of this study was to determine whether quantification of cervicovaginal fluid fetal fibronectin (fFN) improves diagnostic accuracy of spontaneous preterm birth (sPTB) in symptomatic women.Study DesignA prospective blinded predefined secondary analysis of a larger study of cervicovaginal fluid fFN concentration (nanograms per milliliter) in women symptomatic of preterm labor (n =300 women; 22-35 weeks' gestation) with a Hologic 10Q system (Hologic, Marlborough, MA). Clinicians were blinded to the result until after the delivery, but the qualitative Hologic TLIIQ fFN result was made available.ResultsThe positive predictive value for sPTB (<34 weeks' gestation) increased from 19%, 32%, 61%, and 75% with increasing thresholds (10, 50, 200, and 500 ng/mL, respectively). Compared with <10 ng/mL fFN, the relative risk of delivery was 5.6 (95% confidence interval [CI], 1.05–29.57), 7.9 (95% CI, 1.38–45.0), 22.8 (95% CI, 3.84–135.5), and 51.3 (95% CI, 12.49–211.2; P < .01).ConclusionQuantitative fFN provides thresholds (10 and 200 ng/mL) in addition to the qualitative method (50 ng/mL) to discriminate the risk of sPTB in symptomatic women.

AB - ObjectiveThe purpose of this study was to determine whether quantification of cervicovaginal fluid fetal fibronectin (fFN) improves diagnostic accuracy of spontaneous preterm birth (sPTB) in symptomatic women.Study DesignA prospective blinded predefined secondary analysis of a larger study of cervicovaginal fluid fFN concentration (nanograms per milliliter) in women symptomatic of preterm labor (n =300 women; 22-35 weeks' gestation) with a Hologic 10Q system (Hologic, Marlborough, MA). Clinicians were blinded to the result until after the delivery, but the qualitative Hologic TLIIQ fFN result was made available.ResultsThe positive predictive value for sPTB (<34 weeks' gestation) increased from 19%, 32%, 61%, and 75% with increasing thresholds (10, 50, 200, and 500 ng/mL, respectively). Compared with <10 ng/mL fFN, the relative risk of delivery was 5.6 (95% confidence interval [CI], 1.05–29.57), 7.9 (95% CI, 1.38–45.0), 22.8 (95% CI, 3.84–135.5), and 51.3 (95% CI, 12.49–211.2; P < .01).ConclusionQuantitative fFN provides thresholds (10 and 200 ng/mL) in addition to the qualitative method (50 ng/mL) to discriminate the risk of sPTB in symptomatic women.

KW - fetal fibronectin

KW - preterm birth

KW - RISK

KW - PREDICTOR

KW - ACCURACY

KW - DELIVERY

U2 - 10.1016/j.ajog.2012.10.890

DO - 10.1016/j.ajog.2012.10.890

M3 - Article

C2 - 23164760

VL - 208

SP - 122.e1-122.e6

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

IS - 2

M1 - N/A

ER -

Evaluation of a quantitative fetal fibronectin test for spontaneous preterm birth in symptomatic women

Abstract

Keywords

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