Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length
Presentated orally at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 26-31, 2009.
Received 18 February 2009; received in revised form 14 April 2009; accepted 5 June 2009.
Objective
The purpose of this study was to evaluate combined fetal fibronectin (fFN) test result and cervical length (CL) as predictors of spontaneous preterm birth in asymptomatic twin pregnancies.
Study Design
We examined a retrospective cohort of 155 twin pregnancies with combined fFN and CL testing between 22 and 32 weeks gestation.
Results
A positive fFN test result at 22-32 weeks or a CL <20 mm increased the risk of spontaneous preterm birth at <37, <34, <32, <30, and <28 weeks' gestation. The combination of a positive fFN test result and CL<20 mm had a significantly higher positive predictive value for delivery at all gestational ages than either positive test alone. On adjusted analysis, a positive fFN test result was a stronger predictor of spontaneous preterm birth than a short CL.
Conclusion
In asymptomatic twin pregnancies, fFN and CL testing between 22 and 32 weeks gestation can identify pregnancies that are at significantly increased risk for preterm birth, including deliveries at <28 weeks' gestation.
aMaternal Fetal Medicine Associates, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY
bDepartment of Obstetrics and Gynecology, Metropolitan Hospital Center, New York, NY
Reprints: Nathan S. Fox, MD, Maternal Fetal Medicine Associates, PLLC, 70 East 90th St, New York, NY 10128
Authorship and contribution to the article is limited to the 6 authors indicated. There was no outside funding or technical assistance with the production of this article.
Cite this article as: Fox NS, Saltzman DH, Klauser CK, et al. Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length. Am J Obstet Gynecol 2009;201:313.e1-5.
ABSTRACT