Failure of cervical fibronectin to predict premature delivery in a population of monofetal pregnancies with idiopathic preterm labor

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 97; no. 1; pp. 35 - 39
• Main Authors: Voluménie, Jean-Luc, Guibourdenche, Jean, Doridot, Virginie, Sibony, Olivier, Oury, Jean-François, Blot, Philippe, Luton, Dominique
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.07.2001; Elsevier
• Subjects: Biological and medical sciences; Cervical fibronectin; Cervix Uteri - chemistry; Delivery, Obstetric; Diseases of mother, fetus and pregnancy; Female; Fibronectins - analysis; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Length of Stay; Longitudinal Studies; Medical sciences; Obstetric Labor, Premature - diagnosis; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Preterm delivery; Preterm labor; Prospective Studies; Sensitivity and Specificity; Time Factors; Tocolysis; Preterm labor; Preterm delivery; Cervical fibronectin; Human; Pregnancy disorders; Premature delivery; Biological marker; Uterine cervix; Fibronectin; Sensitivity; Specificity; Predictive value; Adult; Female; Threatened premature delivery; Predictive factor
• DOI: 10.1016/S0301-2115(00)00504-2
• ISSN: 0301-2115

Objective: The purpose of the study was to evaluate the correlation between the presence of cervical fibronectin in a high-risk population of women with symptoms of preterm labor and the occurrence of preterm delivery or the need for aggressive tocolysis. Study design: One hundred and thirty women presenting with symptoms of threatened preterm labor were included. Cervical sampling for detection of fibronectin was performed on admission and every day until discharge or delivery. Time to delivery, length of hospital stay, use of indomethacin, delivery before 37 weeks of GA, mean term of delivery and failure of tocolysis to prevent delivery were compared to fibronectin test results. Data were analyzed using Student’s t-test for continuous variables and the χ 2 test or Fisher exact test for discrete variables. Results: No correlation could be found between the results of fibronectin cervical sampling on admission and any of the outcome parameters studied. Test performances were low (sensitivity 28%, specificity 57%, positive predictive value 19%, negative predictive value 69%). Results were not modified when the findings of repeated tests were taken into account. Conclusion: Cervical fibronectin failed to discriminate a subgroup of symptomatic women delivering prematurely. The prognostic value of fibronectin testing was not better than clinical data in our series. This observation is in disagreement with previous studies on the diagnostic value of vaginal or cervical fibronectin in preterm labor.