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Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women
BACKGROUND: The prediction of preterm birth (PTB) is important in the management of symptomatic preterm labour women. We evaluated the effectiveness of the foetal fibronectin (fFN) test for predicting PTB in symptomatic preterm labour women with consideration of physiologic changes in cervical lengt...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625081/ https://www.ncbi.nlm.nih.gov/pubmed/31296172 http://dx.doi.org/10.1186/s12884-019-2403-7 |
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author | Jun, Soo Yeun Lee, Ji Young Kim, Hyun-Mi Kim, Mi Ju Cha, Hyun-Hwa Seong, Won Joon |
author_facet | Jun, Soo Yeun Lee, Ji Young Kim, Hyun-Mi Kim, Mi Ju Cha, Hyun-Hwa Seong, Won Joon |
author_sort | Jun, Soo Yeun |
collection | PubMed |
description | BACKGROUND: The prediction of preterm birth (PTB) is important in the management of symptomatic preterm labour women. We evaluated the effectiveness of the foetal fibronectin (fFN) test for predicting PTB in symptomatic preterm labour women with consideration of physiologic changes in cervical length (CL) during pregnancy. METHODS: This prospective study included 85 women with symptomatic preterm labour of a singleton pregnancy. Positive fFN was defined as a fFN level of > 50 ng/mL in cervicovaginal secretion, while a short CL was defined as that below 25th percentile at the corresponding gestational age. We evaluated effectiveness of the fFN test, CL, and the combination of these two tests, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), positive likelihood ratio (LR(+)), negative likelihood ratio (LR(−)) to predict the PTB within 7 and 14 days of testing and PTB at < 34 and 37 weeks of gestation. We also present the odds ratios (ORs) of the test results, defining the women with both negative results as the reference group. RESULTS: Of the 85 women, 31 (36.5%) showed a positive fFN and 44 (51.8%) had a short CL. PTB occurred within 7 and 14 days of testing and before 34 and 37 weeks of gestation in 17.6, 20.0, 23.5 and 49.4% of the women, respectively. The fFN and CL results showed low predictive effectiveness for the studied outcomes with LR(+) (fFN, 1.5–1.9; CL, 1.0–1.5) and LR(−) (fFN, 0.7; CL, 0.7–0.9). The combined use of fFN and CL could not improve these results (LR(+), 1.4–2.3; LR(−), 0.7–0.9). However, the risk of PTB before 37 weeks was increased in women with positive fFN but not CL shortening compared to the reference group (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.1–1.3). The risk of PTB before 34 weeks was increased in both positive fFN and CL compared to the reference group (OR, 8.1; 95% CI, 1.9–34.5). CONCLUSION: Although, our approach could not improve the ability to predict PTB, it could identify women at risk for delivery before 34 or 37 weeks of gestation. Therefore, it could be used to manage women with symptomatic preterm labour. |
format | Online Article Text |
id | pubmed-6625081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66250812019-07-23 Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women Jun, Soo Yeun Lee, Ji Young Kim, Hyun-Mi Kim, Mi Ju Cha, Hyun-Hwa Seong, Won Joon BMC Pregnancy Childbirth Technical Advance BACKGROUND: The prediction of preterm birth (PTB) is important in the management of symptomatic preterm labour women. We evaluated the effectiveness of the foetal fibronectin (fFN) test for predicting PTB in symptomatic preterm labour women with consideration of physiologic changes in cervical length (CL) during pregnancy. METHODS: This prospective study included 85 women with symptomatic preterm labour of a singleton pregnancy. Positive fFN was defined as a fFN level of > 50 ng/mL in cervicovaginal secretion, while a short CL was defined as that below 25th percentile at the corresponding gestational age. We evaluated effectiveness of the fFN test, CL, and the combination of these two tests, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), positive likelihood ratio (LR(+)), negative likelihood ratio (LR(−)) to predict the PTB within 7 and 14 days of testing and PTB at < 34 and 37 weeks of gestation. We also present the odds ratios (ORs) of the test results, defining the women with both negative results as the reference group. RESULTS: Of the 85 women, 31 (36.5%) showed a positive fFN and 44 (51.8%) had a short CL. PTB occurred within 7 and 14 days of testing and before 34 and 37 weeks of gestation in 17.6, 20.0, 23.5 and 49.4% of the women, respectively. The fFN and CL results showed low predictive effectiveness for the studied outcomes with LR(+) (fFN, 1.5–1.9; CL, 1.0–1.5) and LR(−) (fFN, 0.7; CL, 0.7–0.9). The combined use of fFN and CL could not improve these results (LR(+), 1.4–2.3; LR(−), 0.7–0.9). However, the risk of PTB before 37 weeks was increased in women with positive fFN but not CL shortening compared to the reference group (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.1–1.3). The risk of PTB before 34 weeks was increased in both positive fFN and CL compared to the reference group (OR, 8.1; 95% CI, 1.9–34.5). CONCLUSION: Although, our approach could not improve the ability to predict PTB, it could identify women at risk for delivery before 34 or 37 weeks of gestation. Therefore, it could be used to manage women with symptomatic preterm labour. BioMed Central 2019-07-11 /pmc/articles/PMC6625081/ /pubmed/31296172 http://dx.doi.org/10.1186/s12884-019-2403-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Technical Advance Jun, Soo Yeun Lee, Ji Young Kim, Hyun-Mi Kim, Mi Ju Cha, Hyun-Hwa Seong, Won Joon Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
title | Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
title_full | Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
title_fullStr | Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
title_full_unstemmed | Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
title_short | Evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
title_sort | evaluation of the effectiveness of foetal fibronectin as a predictor of preterm birth in symptomatic preterm labour women |
topic | Technical Advance |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625081/ https://www.ncbi.nlm.nih.gov/pubmed/31296172 http://dx.doi.org/10.1186/s12884-019-2403-7 |
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