Failure of cervical fibronectin to predict premature delivery in a population of monofetal pregnancies with idiopathic preterm labor

Objective: The purpose of the study was to evaluate the correlation between the presence of cervical fibronectin in a high-risk population of women wi th symptoms of preterm labor and the occurrence of preterm delivery or the need for aggressive tocolysis Study design: One hundred and thirty women pr esenting with symptoms of threatened preterm labor were included. Cervical sampling for detection of fibronectin was performed on admission and every day until discharge or delivery. Time to delivery, length of hospital stay, use of indomethacin, delivery before 37 weeks of GA, mean term of delivery and failure of tocolysis to prevent delivery were compared to fibronectin test results. Data were analyzed using Student's t-test for continuous vari ables and the chi (2) test or Fisher exact test for discrete variables. Res ults: No correlation could be found between the results of fibronectin cerv ical sampling on admission and any of the outcome parameters studied. Test performances were low (sensitivity 28%, specificity 57%, positive predictiv e value 19%, negative predictive value 69%). Results were not modified when the findings of repeated tests were taken into account. Conclusion: Cervic al fibronectin failed to discriminate a subgroup of symptomatic women deliv ering prematurely. The prognostic value of fibronectin testing was not bett er than clinical data in our series. This observation is in disagreement wi th previous studies on the diagnostic value of vaginal or cervical fibronec tin in preterm labor. (C) 2001 Elsevier Science Ireland Ltd. All rights res erved.