Quantitative fFN: can it guide triage for preterm labour symptoms?

  • Mahomed K & al.
  • Eur J Obstet Gynecol Reprod Biol X
  • 1 Oct 2019

  • International Clinical Digest
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Takeaway

  • Quantitative foetal fibronectin (fFN) may improve triage of patients presenting with symptoms of preterm labour (PTL) in an outpatient setting.

Why this matters

  • Preterm delivery is associated with neonatal morbidity and mortality but remains difficult to diagnose correctly.
  • More than 70% presenting with contractions go on to deliver full term.
  • Tests to diagnose preterm labor include fFN; however, many facilities use only qualitative rather than quantitative testing.

Key results

  • Overall preterm birth rate (
  • The unadjusted ORs (95% CIs) for preterm birth
  • ≥10: 3.39 (1.34-8.56);
  • ≥50: 7.11 (3.18-15.9); and
  • ≥200: 12.5 (3.54-44.1).
  • A cutoff of fFN ≥200 ng/mL to predict preterm birth
  • 25% sensitivity,
  • 97.4% specificity,
  • 35.3% positive predictive value, and
  • 95.8% negative predictive value.
  • Study design

    • Retrospective cohort study between 2015 and 2017.
    • Gravidas presenting with symptoms of PTL with intact membranes between 23 and 34 weeks of gestation and with a recorded fFN test were included (447 pregnancies).
    • Funding: None.

    Limitations

    • Retrospective design.
    • Patients with multiple concerning symptoms were not included.