|Fetal Fibronectin Test Performance in Patients at Low Risk for Preterm Delivery|
|Sumithra Jeganathan1, Alexander G. Shilkrut1, Aleksandr M. Fuks2, Sari J. Kaminsky1|
|1Department of Obstetrics and Gynecology, Metropolitan Hospital, New York, NY; USA.
2Department of Obstetrics and Gynecology, Queens Hospital, Health+Hospitals, New York, NY; USA
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Keywords : Preterm Birth, Predictive Value, Pregnancy, Antenatal Corticosteroids
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Objectives :Spontaneous preterm birth is a leading cause of neonatal death. Fetal fibronectin (fFN) testing in cervical secretions between 22-34.6 weeks of gestation is used to predict non-delivery within the next 7 days in patients with symptoms of preterm labor. The objective of this study is to analyze fFN test performance in a group of patients with low risk for preterm delivery that presented with preterm labor symptoms, and to evaluate how the results of fFN testing influenced management decisions.
Materials and Methods:Patients after preterm delivery (gestational age 24.0-36.6 weeks) and patients who underwentfFNtesting in Metropolitan Hospital, NYC Health+Hospitals, New York, NY,between 01-01-2015 to 12-31-2015 were identified and reviewed. Patients with positive fFNtest results (fFN+; >50 ng/dL) were compared to patients with negative fFN test results (fFN-).
Results:Among 77 patients identified, 66 (86%) were fFN- and 11 (14%)fFN+;15 patients (78%) who delivered preterm were not tested with fFN.Preterm birth rate during the study period was 1.9%.There was no difference in maternal or neonatal characteristics between the two groups. Among fFN-, 4patients (6%) delivered preterm, while amongfFN+, none delivered preterm. In both groups,none delivered within 7 days of testing. Compared to fFN-,fFN+ had higher rates of admissions (36% vs 0%; p<0.001) and steroid administration (82% vs 0%; p<0.001).
Conclusion:In this retrospective analysis, use of fFN testing as an initial screening test for patients withsymptoms of preterm labor in this low risk population did not result in improved clinical outcomes and was associated with a higher rates of hospital admissions and steroid administration.
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