A single cervical fetal fibronectin screening test in; population at low risk for preterm delivery: an improvement on clinical indicators?

Faron, Gilles; Boulvain, Michel; Lescrainier, Jean Paul; Vokaer, Alain

doi:10.1111/j.1471-0528.1997.tb11980.x

Cited by 29 publications

(11 citation statements)

References 16 publications

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“…Contradicting observations have been found regarding the role of fFN for predicting preterm births (Faron et al, 1997;Revah et al, 1998;Moore, 1999;Sakai et al, 2003). Our results indicated that fFN had a higher recent predictive value and negative predictive value for predicting preterm birth, but the positive predictive value appeared lower.…”

Section: Relationship Between Ffn and Preterm Birthsupporting

confidence: 49%

Fetal fibronectin detection for preterm birth prediction

et al. 2014

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ABSTRACT. To study preterm birth prediction based on fetal fibronectin (fFN) in pregnant women, we randomly selected 124 patients. Vaginal posterior fornix secretions were analyzed using fFN quick test strips. Leucorrhea routine samples were collected to detect bacterial vaginosis, mycoplasma, and chlamydia. Delivery data at 7 days, 14 days, 34 weeks, and 37 weeks were documented and the sensitivity, specificity, positive predictive value, and negative predictive value were analyzed. Of the 124 cases, we found 2, 4, 10, and 18 cases of maternity within 7 days, 14 days, 34 weeks, and 37 weeks, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 100, 77.8, 6.9, and 100% for 7 days; 75, 78.3, 10.3, and 98.9% for 14 days; 50.0, 78.9, 17.2, and 94.7% for 34 weeks; 33.3, 78.3, 20.7, and 87.4% for 37 weeks, respectively. Except for 18 preterm births, 23 cases were fFN-positive, 17 cases had lower genital tract infection. Eighty- three cases were fFN-negative, of which 18 cases had the lower genital tract infections. This difference was statistically significant (P < 0.05). Eighteen cases (14.5% of the pregnant women) had preterm birth. Ten cases delivered within 34 weeks. The negative predictive value and recent predictive value of fFN testing were higher; the positive predictive value was limited due to the impact of lower genital tract infection. The fFNpositive patients need timely clinical processing. During the pregnancy, monitoring of fFN changes and early detection of abnormalities help to reduce perinatal morbidity and mortality.

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Section: Relationship Between Ffn and Preterm Birthsupporting

confidence: 49%

Fetal fibronectin detection for preterm birth prediction

et al. 2014

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“…There were three studies in asymptomatic women [87][88][89] and five studies in symptomatic women that fulfilled our definition of high-quality test accuracy studies. 85,[90][91][92][93] The methodological quality of the included primary studies is summarised in Figure 8 85 with a summary LR-of 0.50 (95% 0.43-0.59) (χ 2 heterogeneity test p = 0.00) ( Figure 13).…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling

Honest

Ca²,

Durée³

et al. 2009

Health Technol Assess

185

146

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For primary prevention, an effective, affordable and safe intervention applied to all mothers without preceding testing is likely to be the most cost-effective approach in asymptomatic women in early pregnancy. For secondary prevention among women at risk of preterm labour in later pregnancy, a management strategy based on the results of testing is likely to be more cost-effective. Implementation of a treat-all strategy with simple interventions, such as fish oils, would be premature for asymptomatic women. Universal provision of high-quality ultrasound machines in labour wards is more strongly indicated for predicting spontaneous preterm birth among symptomatic women than direct management, although staffing issues and the feasibility and acceptability to mothers and health providers of such strategies need to be explored. Further research should include investigations of low-cost and effective tests and treatments to reduce and delay spontaneous preterm birth and reduce the risk of perinatal mortality arising from preterm birth.

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“…The presence or absence of fFN detected by the test is one of the best predictors of preterm birth found to date, particularly for the determination of which women presenting with PTL are not at immediate risk for preterm birth . Numerous systematic reviews/meta‐analyses, clinical trials and cohort studies reporting diagnostic test properties of the fFN test in different obstetrical populations have demonstrated high negative predictive values (between 75% and 100%), indicating that women who test negative for fFN have a high probability of not delivering within the subsequent 7–14 days. The utilisation of the fFN test for the evaluation of women presenting with PTL has achieved measurable reductions in hospital admissions, maternal transfer rates and length of stay for PTL in numerous settings; however, to our knowledge, an evaluation at a health system level has not been carried out previously.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the impact of fetal fibronectin test implementation on hospital admissions for preterm labour inOntario: a multiple baseline time‐series design

Fell

Sprague

Grimshaw

et al. 2013

BJOG

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Objective To determine the impact of a health system-wide fetal fibronectin (fFN) testing programme on the rates of hospital admission for preterm labour (PTL).Design Multiple baseline time-series design.Setting Canadian province of Ontario. Methods International Classification of Diseases codes in a health system-wide hospital administrative database were used to identify the study population and define the outcome measure. An aggregate time series of monthly rates of hospital admissions for PTL was analysed using segmented regression models after aligning the fFN test implementation date for each institution.Main outcome measure Rate of obstetrical hospital admission for PTL.Results Estimated rates of hospital admission for PTL following fFN implementation were lower than predicted had pre-implementation trends prevailed. The reduction in the rate was modest, but statistically significant, when estimated at 12 months following fFN implementation (À0.96 hospital admissions for PTL per 100 preterm births; 95% confidence interval [CI], À1.02 to À0.90, P = 0.04). The statistically significant reduction was sustained at 24 and 36 months following implementation.Conclusions Using a robust quasi-experimental study design to overcome confounding as a result of underlying secular trends or concurrent interventions, we found evidence of a small but statistically significant reduction in the health system-level rate of hospital admissions for PTL following implementation of fFN testing in a large Canadian province.

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A single cervical fetal fibronectin screening test in; population at low risk for preterm delivery: an improvement on clinical indicators?

Cited by 29 publications

References 16 publications

Fetal fibronectin detection for preterm birth prediction

Fetal fibronectin detection for preterm birth prediction

Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling

Evaluation of the impact of fetal fibronectin test implementation on hospital admissions for preterm labour inOntario: a multiple baseline time‐series design

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