FETAL FIBRONECTIN, INTERLEUKIN-6, AND C-REACTIVE PROTEIN ARE USEFUL IN ESTABLISHING PROGNOSTIC SUBCATEGORIES OF IDIOPATHIC PRETERM LABOR

OBJECTIVE: Our purpose was to evaluate fetal fibronectin, interleukin- 6, and C-reactive protein from patients with preterm labor to establis h prognostic subcategories. STUDY DESIGN: Thirty-seven patients with p reterm labor had cervical fetal fibronectin and plasma C-reactive prot ein sampled. Eighteen of these patients had amniotic fluid interleukin -6 levels measured. Outcome variables were (1) delivery before 34 week s and (2) delivery within 48 hours. RESULTS: Detectable cervical fetal fibronectin identified 89% of patients who were delivered before 34 w eeks' gestation. Interleukin-6 > 1500 pg/ml identified 88% of patients who were delivered within 48 hours. C-reactive protein > 1.5 mg/dl co rrelated with elevated interleukin-6 levels (p < 0.001). CONCLUSIONS: Three subcategories of idiopathic preterm labor were evident: (1) feta l fibronectin nondetectable (37% likely to be delivered before 34 week s), (2) fetal fibronectin detectable but interleukin-6 < 1500 pg/ml (7 9% likely to be delivered before 34 weeks but 85% with >48 hours' late ncy), and (3) fetal fibronectin present and interleukin-6 > 1500 pg/ml (91% likely to be delivered with < 48 hours' latency).