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Evaluation of additive effect of quantitative fetal fibronectin to cervical length for prediction of spontaneous preterm birth among asymptomatic low-risk women
| Content Provider | Scilit |
|---|---|
| Author | Jwala, Sushma Tran, Tino L. Terenna, Courtney McGregor, Ali Andrel, Jocelyn Leiby, Benjamin E. Baxter, Jason K. Berghella, Vincenzo |
| Copyright Year | 2016 |
| Description | Journal: Acta Obstetricia et Gynecologica Scandinavica To evaluate the possible additive effect of quantitative fetal fibronectin to transvaginal ultrasound cervical length measurement between 18(0/7) -23(6/7) weeks for prediction of spontaneous preterm birth at < 37(0/7) weeks among asymptomatic low-risk women.A prospective observational study of asymptomatic women with singleton gestations between 18(0/7) -23(6/7) weeks and no prior spontaneous preterm birth was performed. Women with multiple gestations, rupture of membranes, vaginal bleeding, intercourse or vaginal exam within 48 hours of enrollment were excluded. Physicians were blinded to the quantitative fetal fibronectin levels, but the cervical length measurements were made available. The primary outcome was spontaneous preterm birth < 37(0/7) weeks.Of the 528 asymptomatic low-risk women who were prospectively enrolled, 36 (6.82%) had spontaneous preterm birth < 37(0/7) weeks. Using Receiver-Operating characteristic curve, fetal fibronectin value of ≥ 5ng/mL was identified as the optimal cut-off for predicting spontaneous preterm birth < 37(0/7) weeks. As compared with cervical length ≤ 20mm alone, with the use of cervical length ≤ 20mm or quantitative fetal fibronectin ≥ 5ng/mL as screening criteria for prediction of spontaneous preterm birth < 37(0/7) weeks; sensitivity improved from 11.11% to 61.11%, specificity decreased from 99.59% to 55.08%, positive predictive value decreased from 66.67% to 9.05%, negative predictive value marginally improved from 93.87% to 95.09% and predictive accuracy decreased from 93.56% to 55.49%.Although the sensitivity has improved, other predictive statistics and predictive accuracy did not improve by the addition of mid-trimester quantitative fetal fibronectin to cervical length measurement. Therefore, addition of mid-trimester quantitative fetal fibronectin to cervical length measurement cannot be recommended at this time for prediction of spontaneous preterm birth < 37(0/7) weeks in asymptomatic low-risk women. This article is protected by copyright. All rights reserved. |
| Ending Page | 955 |
| Starting Page | 948 |
| ISSN | 00221295 |
| e-ISSN | 16000412 |
| DOI | 10.1111/aogs.12907 |
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Issue Number | 8 |
| Volume Number | 95 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2016-05-26 |
| Access Restriction | Open |
| Subject Keyword | Journal: Acta Obstetricia et Gynecologica Scandinavica Obstetrics and Gynecology Quantitative Fetal Fibronectin Spontaneous Preterm Birth Transvaginal Ultrasound Cervical Length |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
