Development and validation of a tool incorporating quantitative fetal fibronectin to predict spontaneous preterm birth in symptomatic women

Kuhrt, Katy; Hezelgrave, Natasha L.; Foster, Claire; Seed, Paul; Shennan, Andrew

doi:10.1002/uog.14894

Cited by 38 publications

(45 citation statements)

References 18 publications

(22 reference statements)

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“…This is in accordance with the theory that fFN levels are increased in association with disruption between the choriodecidual fusion and imminence of labour [11]. Recently, Kuhrt et al [12] developed and validated a new predictive model for spontaneous threatened preterm labour in symptomatic women using a qfFN. The researchers assessed 382 pregnant women between 22 and 35 + 6 weeks of gestation, and the model was developed on the first 190 women and validated on the remaining 192.…”

Section: Discussionsupporting

confidence: 48%

Clinical Application of Quantitative Foetal Fibronectin for the Prediction of Preterm Birth in Symptomatic Women

Radford

Costa²,

Júnior³

et al. 2017

Gynecol Obstet Invest

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Aim: To evaluate the clinical application of the new Hologic quantitative foetal fibronectin (qfFN) bedside test for the prediction of spontaneous preterm birth (sPTB) in patients with symptoms suggestive of spontaneous threatened preterm labour (sPTL). Methods: A prospective observational study with 154 pregnant women presenting signs and symptoms of sPTL was conducted. These women were subjected to a qfFN test between 22 and 35 weeks of gestation For each cut-off threshold, the ability to predict sPTB at within 14 days of conducting the test and <37 weeks was assessed by calculating the positive predictive value (PPV), negative predictive value (NPV), likelihood ratios, odds ratios, sensitivity, and specificity. Results: For the outcome of delivery within 14 days of the test, qfFN <10 ng/mL had a 100% NPV and >200 ng/mL produced a 50.0% PPV; thus, qfFN added enhanced discrimination between high- and low-risk patients. The overall rate of sPTB (<37) was 13.3% (16/120), which increased progressively with increasing levels of fFN, with rates of 9.8% (8/81), 11.5% (3/26), 14.2% (1/7), 50% (3/6) within the 4 categories (fFN 0-9, 10-49, 50-200, 200+) respectively. Conclusions: The use of the qfFN testing in symptomatic patients allowed for more accurate identification of women at risk of sPTB and thus more directed management.

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Section: Discussionsupporting

confidence: 48%

Clinical Application of Quantitative Foetal Fibronectin for the Prediction of Preterm Birth in Symptomatic Women

Radford

Costa²,

Júnior³

et al. 2017

Gynecol Obstet Invest

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“…59–61 In a pre-specified secondary analysis of a prospective blinded study, the positive predictive value for SPTB o 34 weeks gestation increased from 19%, 32%, 61%, and 75% with increasing thresholds (10, 50, 200, and 500 ng/mL, respectively). 59 The combination of quantitative FFN testing and CL assessment may further increase predictive value, but data remains limited to preliminary observational studies.…”

Section: Introductionmentioning

confidence: 99%

Predicting preterm birth: Cervical length and fetal fibronectin

Son

Miller

2017

Seminars in Perinatology

114

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Spontaneous preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, and accounts for a significant global health burden. Several obstetric strategies to screen for spontaneous preterm delivery, such as cervical length and fetal fibronectin measurement, have emerged. However, the effectiveness of these strategies relies on their ability to accurately predict those pregnancies at increased risk for spontaneous preterm birth (SPTB). Transvaginal cervical shortening is predictive of preterm birth and when coupled with appropriate preterm birth prevention strategies, has been associated with reductions in SPTB in asymptomatic women with a singleton gestation. The use of qualitative fetal fibronectin may be useful in conjunction with cervical length assessment in women with acute preterm labor symptoms, but data supporting its clinical utility remain limited. As both cervical length and qualitative fetal fibronectin have limited capacity to predict preterm birth, further studies are needed to investigate other potential screening modalities.

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“…Quantitative fFN also helps identify those at low risk with a known short cervix (< 25 mm), with 90% of women delivering after 34 weeks' gestation if the fFN is < 10 ng/mL. Combining quantitative fFN with risk factors and cervical length provides exciting opportunities for tailoring prediction to the individual.…”

Section: Discussionmentioning

confidence: 99%

“…In asymptomatic high‐risk women, fFN has a negative predictive value for spontaneous preterm birth before 30 weeks of 98.6% and a positive predictive value of 13.6% (when using the conventional fFN threshold of 50 ng/mL). When combined with cervical length and clinical history, the predictive performance of fFN is enhanced further.…”

Section: Introductionmentioning

confidence: 99%

Ability of a preterm surveillance clinic to triage risk of preterm birth: a prospective cohort study

Min

Watson

Hezelgrave

et al. 2016

Ultrasound Obstet Gynecol

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Development and validation of a tool incorporating quantitative fetal fibronectin to predict spontaneous preterm birth in symptomatic women

Abstract: ObjectiveTo develop a reliable and validated tool for prediction of spontaneous preterm birth (sPTB)

Cited by 38 publications

References 18 publications

Clinical Application of Quantitative Foetal Fibronectin for the Prediction of Preterm Birth in Symptomatic Women

Clinical Application of Quantitative Foetal Fibronectin for the Prediction of Preterm Birth in Symptomatic Women

Predicting preterm birth: Cervical length and fetal fibronectin

Ability of a preterm surveillance clinic to triage risk of preterm birth: a prospective cohort study

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