Evaluation of quantitative fFn test in predicting the risk of preterm birth

Centra, Michela; Coata, Giuliana; Picchiassi, Elena; Alfonsi, L.; Meniconi, Samanta; Bini, Vittorio; Tommaso, Maria Rosaria Di; Cozzolino, Mauro; Facchinetti, Fabio; Ferrari, Francesca; Gervasi, Maria Teresa; Rusconi, Silvia; Todros, Tullia; Frisina, Valentina; Rizzo, Nicola; Bisulli, M.; Renzo, Gian Carlo Di

doi:10.1515/jpm-2015-0414

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…However, the specificity at 10 ng/ml was the lowest among the four thresholds, meaning that it may misclassify low‐risk women as high‐risk for sPTB, and increase additional risk from unnecessary interventions. In fact, a majority of quantitative fFN measurements fell below this threshold indicating an available application of 10 ng/ml threshold for a majority of patients who are theoretically at high‐risk of preterm birth 11,12 . Furthermore, meta‐regression and subgroup analysis confirmed significant usefulness of the 10 ng/ml threshold in predicting sPTB among asymptomatic women who are unlikely to deliver preterm.…”

Section: Discussionmentioning

confidence: 86%

“…Table 1 presents the data from the included studies. Of the 15 studies, 13 described diagnostic performance of 10 ng/ml, 6,10–21 15 used 50 ng/ml, 6,10–23 12 used 200 ng/ml, 6,10–19,21 and 7 used 500 ng/ml 6,10,11,13,14,19,21 . Detailed information regarding study design, sample size, age of participants, and the thresholds used in each study is provided in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic accuracy of quantitative fetal fibronectin to predict spontaneous preterm birth: A meta‐analysis

Chen¹,

Gong

Zheng³

et al. 2020

Intl J Gynecology & Obste

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Background Use of quantitative fetal fibronectin (fFN) testing to predict spontaneous preterm birth (sPTB) is gaining attention owing to its absolute measurement of fFN concentration and increased positive predictive value compared with qualitative testing. Objective To assess the predictive values of quantitative fFN for sPTB in different predefined thresholds using systematic review and meta‐analysis. Search strategy Five major databases (PubMed, ScienceDirect, Web of Science, Embase, Cochrane library) were searched for eligible studies. Selection criteria Observational studies of the diagnostic accuracy of different quantitative fFN thresholds on delivery outcomes were included. Data collection and extraction Articles were reviewed independently by two authors and data were extracted. Sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curves were extracted and calculated. Main results Fifteen studies were included. To detect sPTB at less than 34 weeks of gestation, pooled sensitivities for thresholds of 10, 50, 200, and 500 ng/ml were 0.78, 0.56, 0.33, and 0.11, respectively. Pooled specificities were 0.63, 0.84, 0.96, and 0.99, respectively. Conclusions Based on the results of the meta‐analysis, the threshold of 10 ng/ml fFN may be a new choice for the prediction of sPTB. The improved diagnostic accuracy of quantitative testing over qualitative testing can provide additional discriminatory information for clinical practice.

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Section: Discussionmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of quantitative fetal fibronectin to predict spontaneous preterm birth: A meta‐analysis

Chen¹,

Gong

Zheng³

et al. 2020

Intl J Gynecology & Obste

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“…There are publications comparing the predictive strength of qualitative and quantitative fFN measurements (16,17). A recent study showed that quantitative fFN test alone is equal effective to the combination of cervical length and qualitative fFN test (18).…”

Section: Discussionmentioning

confidence: 99%

Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

Çelik

Engin

Yıldırım

2020

Gynecol Obstet Reprod Med

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OBJECTIVE: Digital cervical evaluation has been used to determine the likelihood of vaginal delivery which is considered by many women to be non-tolerable. Recently, alternative approaches such as transperineal ultrasound, fetal fibronectin test in cervicovaginal secretions have been investigating for the prediction of the delivery route. We aimed to study whether the usefulness of qualitative fetal fibronectin test in cervicovaginal secretions for the prediction of vaginal delivery in pregnant women at postterm induced with dinoprostone. STUDY DESIGN:A total of 32 nulliparous pregnant women at postterm were enrolled in this prospective observational study. Fetal fibronectin test was applied to all participated women before the induction with dinoprostone and transvaginal ultrasonography was performed to measure cervical length. RESULTS:The women having positive fetal fibronectin test result gave birth through vaginal route, except one case. Although there is no statistically significant difference, the shorter cervical length was associated with vaginal delivery in our population. CONCLUSION:Fetal fibronectin test has a predictive value for delivery route in nulliparous women at postterm. Fetal fibronectin test may be used as a "rule out" test because the rate of fetal fibronectin positivity was found to be higher in patients who gave birth via vaginal route. As also shown in our study, although there is no statistically significant difference, the pregnant women with shorter cervical length might have a high possibility to achieve vaginal delivery.

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“…Initially, the fetal fibronectin test was scored as positive or negative, with a cutoff of 50ng/ml [16, 18-28, 30, 31]. Subsequently, a quantitative test has been developed, and there is evidence that measuring the absolute concentration of fetal fibronectin is more informative than a categorical value of positive/ negative [32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the issue of whether an increased concentration of fetal fibronectin in cervicovaginal fluid represents a marker of upper genital tract infection in patients with an episode of preterm labor remains unresolved. Some recent studies have evaluated the usefulness of quantitative fetal fibronectin testing to identify patients at risk for impending preterm delivery [32][33][34][35][36][37][108][109][110][111][112][113][114][115][116][117][118]. This study was conducted to determine if a quantitative cervical fetal fibronectin test can predict intraamniotic infection, intra-amniotic inflammation, histologic chorioamnionitis and a short amniocentesis-to-delivery interval in patients with preterm labor and intact membranes.…”

Section: Introductionmentioning

confidence: 99%

A high concentration of fetal fibronectin in cervical secretions increases the risk of intra-amniotic infection and inflammation in patients with preterm labor and intact membranes

Romero

Park

et al. 2019

Journal of Perinatal Medicine

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Objective To determine whether the risk of intra-amniotic infection/inflammation and spontaneous preterm delivery (SPTD) varies as a function of the concentration of cervical fetal fibronectin (fFN) in patients with preterm labor and intact membranes. Methods This prospective study included 180 patients with preterm labor and intact membranes who had a sample collected for quantitative fFN measurement and underwent amniocentesis. Amniotic fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas. Intra-amniotic inflammation was defined as an amniotic fluid matrix metalloproteinase-8 concentration >23 ng/mL. Results (1) The prevalence of intra-amniotic infection/inflammation and SPTD within 7 days was 32.2% (58/180) and 33.9% (61/178), respectively; (2) The higher the fFN concentration, the greater the risk of intra-amniotic infection/inflammation and SPTD within 7 days (P<0.001, respectively); (3) An fFN concentration 150 ng/mL had a better diagnostic performance than an fFN 50 ng/mL in the identification of intra-amniotic infection/inflammation and SPTD within 7 days; (4) Among the patients with an fFN <50 ng/mL, intra-amniotic infection/inflammation was identified in 7.6% (6/79) of patients and 66.7% (4/6) delivered within 7 days. Conclusion The higher the concentration of fFN, the greater the risk of intra-amniotic infection/inflammation and SPTD in patients with preterm labor and intact membranes.

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Evaluation of quantitative fFn test in predicting the risk of preterm birth

Abstract: The QfFN thresholds of tests are a useful tool to distinguish pregnant women for PTB prediction risk <34 weeks' gestation.

Cited by 10 publications

References 22 publications

Diagnostic accuracy of quantitative fetal fibronectin to predict spontaneous preterm birth: A meta‐analysis

Diagnostic accuracy of quantitative fetal fibronectin to predict spontaneous preterm birth: A meta‐analysis

Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

A high concentration of fetal fibronectin in cervical secretions increases the risk of intra-amniotic infection and inflammation in patients with preterm labor and intact membranes

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