FETAL FIBRONECTIN DETECTION FOR PREDICTION OF PRETERM BIRTH IN LOW-RISK WOMEN

Objective To evaluate the clinical value of cervical fetal fibronectin detection by a quantitative enzyme-linked immunosorbent assay (ELISA) (PTDcheck(R), Adeza Biomedical, Sunnyvale, California, USA) as a scre ening tool for the prediction of preterm contractions and preterm deli very in an unselected population of pregnant women globally considered to be at low risk for preterm delivery (n = 133). Design A prospectiv e study in which cervical fetal fibronectin samples were collected at two-week intervals between 26 and 36 weeks of gestation. Setting A reg ional training hospital. Subjects One hundred and thirty-three singlet on pregnancies presenting consecutively at an antenatal clinic. Main o utcome measure Occurrence of preterm contractions and preterm delivery (delivery at < 37 weeks of gestation). Results Twenty-four (18%) pati ents were considered positive for the presence of fetal fibronectin. O verall 15 patients (11%) developed preterm contractions and, despite t herapeutic intervention, 10 patients (8%) were delivered preterm. As a predictor for preterm contractions, cervical fetal fibronectin detect ion had a sensitivity of 47%, a specificity of 86%, a positive predict ive value of 29% and a negative predictive value of 93%. As a predicto r for preterm delivery, cervical fetal fibronectin detection had a sen sitivity of 60%, a specificity of 85%, a positive predictive value of 25% and a negative predictive value of 96%. Conclusions Cervical fetal fibronectin determinations at a two-week sampling frequency for predi ction of preterm birth in a general obstetric population at low risk f or preterm birth has limited clinical value as a routinely performed s creening procedure.