Fetal fibronectin detection for prediction of preterm birth in low risk women

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Abstract
Objective To evaluate the clinical value of cervical fetal fibronectin detection by a quantitative enzyme‐linked immunosorbent assay (ELISA) (PTDcheck®, Adeza Biomedical, Sunnyvale, California, USA) as a screening tool for the prediction of preterm contractions and preterm delivery in an unselected population of pregnant women globally considered to be at low risk for preterm delivery (n = 133). Design A prospective study in which cervical fetal fibronectin samples were collected at two‐week intervals between 26 and 36 weeks of gestation. Setting A regional training hospital. Subjects One hundred and thirty‐three singleton pregnancies presenting consecutively at an antenatal clinic. Main outcome measure Occurrence of preterm contractions and preterm delivery (delivery at < 37 weeks of gestation). Results Twenty‐four (18 %) patients were considered positive for the presence of fetal fibronectin. Overall 15 patients (11%) developed preterm contractions and, despite therapeutic intervention, 10 patients (8 %) were delivered preterm. As a predictor for preterm contractions, cervical fetal fibronectin detection had a sensitivity of 47%, a specificity of 86%, a positive predictive value of 29% and a negative predictive value of 93%. As a predictor for preterm delivery, cervical fetal fibronectin detection had a sensitivity of 60%, a specificity of 85Y0, a positive predictive value of 25% and a negative predictive value of 96%. Conclusions Cervical fetal fibronectin determinations at a two‐week sampling frequency for prediction of preterm birth in a general obstetric population at low risk for preterm birth has limited clinical value as a routinely performed screening procedure.

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