Vaginal fetal fibronectin as a predictor of spontaneous preterm delivery after multifetal pregnancy reduction

Ashley S. Roman, Andrei Rebarber, Heather Lipkind, Jeanine Mulholland, Victoria Minior, Daniel Roshan

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective: The study was undertaken to assess the validity of vaginal fetal fibronectin assay as a screening test for spontaneous preterm delivery in asymptomatic patients who have undergone multifetal pregnancy reduction (MFPR). Study design: A historic cohort of 63 patients who underwent MFPR between 10 and 14 weeks of gestation was identified. All patients underwent serial vaginal fetal fibronectin sampling every 2 to 3 weeks from 22 weeks of gestation until delivery or 32 weeks of gestation. The fetal fibronectin concentration was measured by enzyme-linked immunosorbent assay, with 50 ng/mL or greater indicating a positive result. Charts were reviewed for fetal fibronectin results and pregnancy outcome data. Groups were compared by use of Fisher exact test. Results: There were 13 singleton and 50 twin gestations after MFPR. A median of 4 fetal fibronectin assays were performed per patient. A total of 234 fetal fibronectin assays were performed with 222 (94.9%) negative results and 12 (5.1%) positive results. Overall, 41.3% of gestations were delivered spontaneously before 37 weeks; 7.9% were delivered before 34 weeks. The mean interval between tests was 17.8 days (±7.2 days). For delivery within 2 and 3 weeks of a single test, fetal fibronectin had a sensitivity of 66.7% and 50%, a specificity of 95.7% and 96.1%, a positive predictive value of 16.7% and 25%, and a negative predictive value of 99.5% and 98.6%, respectively. Conclusion: The fetal fibronectin test has similar validity to predict spontaneous preterm delivery in these high-risk pregnancies as in previously published cohorts.

Original languageEnglish
Pages (from-to)142-146
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume190
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Keywords

  • Fetal fibronectin
  • Multifetal pregnancy reduction
  • Preterm delivery

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