339: Predictors of preterm birth: a comparison of cervical length, fetal fibronectin and fetal adrenal gland enlargement

Salari, Kataneh; Treadwell, Marjorie C.; Thompson, Katherine H.

doi:10.1016/j.ajog.2014.10.385

Cited by 2 publications

(1 citation statement)

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“…This finding is consistent with an investigation performed by Salari, who likewise examined the fetal adrenal gland in a cohort of asymptomatic women 17 . Several explanations may be offered as to the reason for these discrepant findings.…”

Section: Discussionsupporting

confidence: 92%

Ultrasound Measurement of the Fetal Adrenal Gland as a Predictor of Spontaneous Preterm Birth

Hoffman

Turan

Parker

et al. 2016

Obstetrics &Amp; Gynecology

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Objective To estimate whether ultrasound measurement of the fetal adrenal gland remote from delivery in asymptomatic women can accurately predict spontaneous preterm birth. Methods We conducted a prospective multicenter observational nested cohort study of asymptomatic nulliparous women with a singleton pregnancy to study adverse pregnancy outcomes. Between 22 0/7 and 30 6/7 weeks of gestation, credentialed ultrasonographers measured the width (w), length (l), and when able, depth (d) of the “fetal zone” of the fetal adrenal gland as well as the width (W), length (L) and depth (D) of the total gland. We used the ratios of each measurement (w/W, l/L and d/D) to control for variation in adrenal size by gestational age. The accuracy of each ratio measurement in predicting spontaneous preterm birth <37 0/7 weeks (“SPTB37”) and spontaneous preterm birth <34 0/7 weeks (“SPTB34”) was assessed by receiver operating characteristic (ROC) curves, using area under the curve (AUC). Results Pregnancy outcomes were available for 1,697 women with one or more fetal adrenal gland measurements. SPTB37 and SPTB34 occurred in 82 (4.8%) and 6 women (0.4%), respectively. None of the fetal adrenal gland measurements distinguished spontaneous preterm birth from term birth. The AUCs (95% CIs) for SPTB37 were 0.51 (0.45, 0.58), 0.50 (0.44, 0.56), and 0.52 (0.41, 0.63) for w/W, l/L and d/D ratios, respectively. The AUCs for SPTB34 were 0.52 (0.25, 0.79) and 0.55 (0.31, 0.79) for w/W and l/L ratios. Additionally, none of the means of the gland measurements were statistically different between those delivering at term and spontaneous at preterm (p>0.05). Conclusion Fetal adrenal size, as measured by ultrasound between 22 0/7 and 30 6/7 weeks, is not predictive of spontaneous preterm birth in asymptomatic nulliparous women.

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Section: Discussionsupporting

confidence: 92%

Ultrasound Measurement of the Fetal Adrenal Gland as a Predictor of Spontaneous Preterm Birth

Hoffman

Turan

Parker

et al. 2016

Obstetrics &Amp; Gynecology

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The fetal fibronectin test: 25 years after its development, what is the evidence regarding its clinical utility? A systematic review and meta-analysis

Faron

Balepa

Parra

et al. 2018

The Journal of Maternal-Fetal & Neonatal Medicine

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The fetal fibronectin test should not be used as a screening test for asymptomatic women. For high-risk asymptomatic women, and especially for women with multiple pregnancies, the performance of the fetal fibronectin test was also too low to be clinically relevant. Consensual use as a diagnostic tool for women with suspected preterm labor, the best use policy probably still depends on local contingencies, future cost-effectiveness analysis, and comparison with other more recent available biochemical markers.

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339: Predictors of preterm birth: a comparison of cervical length, fetal fibronectin and fetal adrenal gland enlargement

Cited by 2 publications

References 0 publications

Ultrasound Measurement of the Fetal Adrenal Gland as a Predictor of Spontaneous Preterm Birth

Ultrasound Measurement of the Fetal Adrenal Gland as a Predictor of Spontaneous Preterm Birth

The fetal fibronectin test: 25 years after its development, what is the evidence regarding its clinical utility? A systematic review and meta-analysis

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