Quantitative Fetal Fibronectin to Predict Preterm Birth in Asymptomatic Women at High Risk

Abbott, D; Hezelgrave, Natasha L.; Seed, Paul; Norman, Jane E.; David, Anna L.; Bennett, Phillip R.; Girling, Joanna; Chandirimani, Manju; Stock, Sarah; Carter, Jenny; Cate, R. Ten; Kurtzman, James; Tribe, Rachel M.; Shennan, Andrew

doi:10.1097/aog.0000000000000754

Cited by 83 publications

(92 citation statements)

References 18 publications

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“…We found a uniquely high proportion of women with qfFN concentration 500 ng/ml (15%), compared with other studies of qfFN where concentrations 500 ng/ml (1-5%) [10,11] or even 300 ng/ml (10%) [12] are usually rare.…”

Section: Commentcontrasting

confidence: 68%

“…Our group has previously demonstrated the predictive value of quantitative fFN measurement in women presenting with symptoms of preterm labour, with added risk discrimination over and above the traditional qualitative test [10], as well as M a n u s c r i p t 11 in asymptomatic women at high risk of preterm birth [11]. However, women with bulging fetal membranes were excluded from those analyses.…”

Section: Commentmentioning

confidence: 99%

“…Prior to preterm birth, disturbance of the integrity of the maternal-fetal interface, particularly the partial separation of the decidua from the fetal membranes, is believed to result in release of fFN into the CVF fluid. More recently, enhanced prediction has been demonstrated using a quantitative bedside test (qfFN, Hologic 10Q system) which provides additional incremental thresholds to define variable risk [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Quantitative fetal fibronectin predicts preterm birth in women with bulging fetal membranes

Fiorini

Isted

Hezelgrave

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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Please cite this article as: FIORINI F, ISTED A, HEZELGRAVE NL, SHENNAN AH, Quantitative fetal fibronectin predicts preterm birth in women with bulging fetal membranes, European Journal of Obstetrics and Gynecology and Reproductive Biology (2016), http://dx.doi.org/10. 1016/j.ejogrb.2016.05.046 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. CONCLUSION:Quantitative fFN has a role in predicting spontaneous preterm birth even in women with bulging fetal membranes, suggesting that fFN leakage could potentially be an active process. This may aid the clinical management of this high-risk group in the future.

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confidence: 68%

Section: Commentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantitative fetal fibronectin predicts preterm birth in women with bulging fetal membranes

Fiorini

Isted

Hezelgrave

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The predominant value of fFN is its high negative predictive value; a negative fFN can reclassify a high-risk patient back to background population risk of early delivery [17]. However the high negative predictive value is driven by low prevalence of the condition and most studies demonstrate modest sensitivity; the reason for false negative tests is not clear.…”

Section: Commentmentioning

confidence: 99%

Placental inflammation and its relationship to cervicovaginal fetal fibronectin in preterm birth

Krogt¹,

Ridout

Seed

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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words Main text word count: 1864 words Condensation: 25words:There is a significant association between a positive fetal fibronectin and inflammatory placental pathology. Infective morbidity may be increased in women with a raised quantitative fFN who deliver preterm. Short title: Placental inflammation and fFN in women who deliver preterm Abstract ObjectiveLate miscarriage and preterm birth are frequently thought to be associated with inflammation and infection, although in most cases the underlying cause of early delivery remains unknown. The placenta is the organ that links mother and fetus during pregnancy, and postnatal examination may provide useful information about pathophysiology.The relationship between placental pathological lesions and predictive markers of early delivery has not been explored. We sought to characterize preterm deliveries according to placental pathology and relate these to the performance of reliable predictive markers, fetal fibronectin and cervical length. Study DesignThis is a retrospective subanalysis from a larger prospective cohort study on sonographic cervical length, quantitative fetal fibronectin and risk of spontaneous preterm birth. Our cohort was comprised of high-risk asymptomatic women attending the Prematurity Surveillance Clinic at St Thomas' Hospital between 2002 and 2015, who went on to have a late miscarriage or preterm delivery (16 to 36 +6 weeks') and who had available placental histology.The placental pathology of these preterm deliveries was characterized according to the lesions identified, and categorized (according to the Redman classification) into inflammatory (e.g. chorioamnionitis) or non-inflammatory (histologically normal or vascular lesions indicating e.g. malperfusion).We sought to relate placental findings to the performance of reliable predictive markers, in women who delivered early. Standard clinical cut offs for cervical length (< 25mm) and fetal fibronectin (>50 ng/mL) were used to identify the proportion of preterm births that were accurately predicted by the tests or who showed a false negative result, in relation to their placental histology findings. Binomial logistic regression was carried out to evaluate the relationship between placental inflammation, quantitative fFN and cervical length as continuous variables. Results105 women who had a late miscarriage or preterm delivery (16-36 +6 weeks') and available placenta pathology were identified. 66% (42/64) of those with inflammatory placental pathology had a positive fetal fibronectin swab result compared to 15% (6/41) of those with noninflammatory placental pathology (chi-squared 25.9, 95% CI 31.5 to 65.6, p<0.0001).A logistic regression model subanalysis of women in whom both CL and quantitative fFN results were available (n=66) revealed a highly statistically significant relationship with inflammatory placental lesions (p=0.003 and p=0.001 respectively). Placental inflammation was found to be associated with both increasing levels of fFN and a shortening cervix. ConclusionThere...

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“…Otuz dördüncü gebelik haftasından önce preterm doğum riski için, fibronektin değeri 10 ng/mL ve üzerinde olanlarda pozitif belirleyicilik oranı %16,7, negatif belirleyicilk oranı ise %97,3 olarak bildirilirken; 50 ng/mL ve üzerinde fibronektin saptananlarda pozitif belirleyicilik oranı %23,7, negatif belirleyicilk oranı ise %95,6 olarak bildirilmiştir. 133 …”

Section: Fibronektinunclassified

Prediction and Diagnosis of Preterm Delivery: Review

Çetinkaya¹,

Biberoğlu²,

Kırbaş³

et al. 2017

Turkiye Klinikleri J Gynecol Obst

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Quantitative Fetal Fibronectin to Predict Preterm Birth in Asymptomatic Women at High Risk

Abstract: II.

Cited by 83 publications

References 18 publications

Quantitative fetal fibronectin predicts preterm birth in women with bulging fetal membranes

Quantitative fetal fibronectin predicts preterm birth in women with bulging fetal membranes

Placental inflammation and its relationship to cervicovaginal fetal fibronectin in preterm birth

Prediction and Diagnosis of Preterm Delivery: Review

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