Fetal fibronectin testing for reducing the risk of preterm birth

Berghella, Vincenzo; Hayes, Edward J.; Visintine, John; Baxter, Jason K.

doi:10.1002/14651858.cd006843.pub2

Cited by 153 publications

(85 citation statements)

References 29 publications

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“…Полученные данные еще раз подтверждают, что оценка риска у пациентов с историей преждевременных родов или потерей беременности требует тщательного наблюдения за состоянием шейки матки в сравнении с пациентами без отягощенного анамнеза по невынашиванию [2].…”

Section: Discussionunclassified

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Structure and factors of the risk of premature birth

Marat

Ukybassova

2017

J CLIN MED KAZ

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Objective. To study the structure and risk factors of premature birth.Methods. Prospective open-label non-randomized clinical trial. The study included 11 861 births, including 1806 -premature (15.2%) in the CF "UMS of the National Research Center for Maternity and Childhood." The odds ratio (OR), the confidence interval (CI) of risk factors for the development of preterm birth have been calculated.Results. When studying the social portrait of prematurely giving birth to women: the level of education (OR -2.7, SE -0.29, CI (95%) 1.5-4.8;) employment (OR-2.4, SE-0, 29; CI (95%) 1.3-4.1;) and the woman's place of residence (OR 1.5, SE 0.29, CI 95% 0.9-2.7) are statistically significant risk factors for premature birth. The study of obstetrical anamnesis of pregnant women revealed the following: 14.2% -primitive, 85.8% -repeat pregnancy, 26.3% -with a syndrome of previous perinatal losses (2 or more spontaneous abortions), 32.2% -previous premature births, 2, 4% -with cervical insufficiency.Conclusion. The main risk factors for premature birth are cervical insufficiency, repeated pregnancies with a parity of more than 4 (OS-1.19, SE-0.3, CI (95%) 0.7-2.2;), the presence of premature birth and fetal loss in the history (OR-2.66, SE-0.35, CI (95%), 1.3-5.3;), birth of small children (OR-2.38; SE-0.37; CI (95%) 1.2-5.1;).The social portrait of women with preterm birth appears as follows: age 20 to 34 years, predominantly in rural areas, housewives with low and medium education, with habitual loss of pregnancy or previous premature birth, cervical insufficiency.Family planning, pre-birth training for a prospective mother and conducting preventive measures in pregnant high-risk groups for premature birth can be a condition for reducing the frequency of preterm labor.Key words: premature births, structure and factors of the risk of premature birth. Мақсаты.Мерзімінен бұрын босану құрылымы және даму қауіп жағдайларын меңгеру. Зерттеудің әдістері. Проспективтік ашық рандомизирленбеген клиникалық зерттеу. Зерттеуге «Ана мен бала ұлттық ғылыми орталығында UМС» КФ 11 861 босану кіргізілді, оның ішінде 1806 (15,2%) мерзімінен бұрын босану. Мерзімнен бұрын босану дамуының мүмкіншілік арақатынасы (МА), сенімгерлік межелдемесі (СМ) есептелді. Structureдоверительного интервала (ДИ) факторов риска развития преждевременных родов. Нәтижелері. Мерзімінен бұрын босанған әйелдердің әлеуметтік бейнесі зерттеу кезінде: білім деңгейі (ОШ -2,7; SE -0,29; ДИ (95%) 1,5-4,8;), жұмысбастылық (ОШ-2,4; SE -0,29; ДИ (95%) 1,3-4,1;) және әйелдің тұрғылықты жері (ОШ -1,5;SE -0,29; ДИ (95%) 0,9-2,7;) мерзімінен бұрын босану дамуының статистикалық маңызы бар факторлары болып табылады.Акушерлік анамнезін тексеру барысында келесі анықталды: 14,2% -алғаш жүктілер, 85,8% -қайта жүктілер, 26,3% -алдында болған перинаталдық жоғалту синдромымен (2 және жоғары өздігінен түсіктер), 32,2% -алдында болған мерзімінен бұрын босанулар, 2,4% -цервикальдық жетіспеушлік.Қорытынды. Истмикалық-цервикалдық жетіспеушлік, 4-тен жоғары босанулар (ОШ-1,19; SE -0,3; Д...

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Section: Discussionunclassified

“…2 Отделение женских болезней, "University Medical Center" Национальный научный центр материнства и детства, Астана, Казахстан.…”

Section: Cтруктура и факторы риска преждевременных родовunclassified

Structure and factors of the risk of premature birth

Marat

Ukybassova

2017

J CLIN MED KAZ

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“…A positive fFN test in vaginal fluids is the most accurate investigation in predicting spontaneous preterm birth (PTB) within 7-10 days among women with symptoms of threatened PTD and improves the predictive value of cervical ultrasonography to identify patients at risk [84]. A fFN positive test represents a powerful marker of PTD when measured at or after 22-24 weeks of gestation in asymptomatic high-risk women [85].…”

Section: Diagnostic Toolsmentioning

confidence: 99%

The obstetric syndromes: clinical relevance of placental hormones

Severi

Bonis

Vellucci

et al. 2013

Expert Review of Endocrinology & Metabolism

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Preterm delivery, preeclampsia and intrauterine growth restriction are the major diseases of pregnancy. A key role in their pathogenesis is played by the placenta, which is the source of hormones and other important regulatory molecules providing the metabolic and endocrine homeostasis of the fetal-placental unit. Since obstetric syndromes are characterized by important maternal and neonatal morbidity and mortality worldwide, numerous efforts have been made over the years to prevent and treat them. Due to their complex pathogenesis, however, the therapy is poor and not very effective. Therefore, great emphasis is currently given to the prevention of these diseases through the identification of biochemical and biophysical markers, among which placental factors play a crucial role. The increasing knowledge of the role of placental molecules can indeed lead to the development of new therapeutic and diagnostic tools. The obstetric syndromes: clinical relevance of placental hormonesExpert Rev. Endocrinol. Metab. 8(2), 127-138 (2013)

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“…This finding could explain why fFN has failed to change clinical practice in studies where clinicians were randomized to know the test results of fFN tests versus being blinded to the results. [24][25][26] Further research is clearly needed to identify a test that would be more effective than either phIGFBP-1 or fFN in correctly identifying women who will not deliver preterm or within a defined period. Until the time when a better test is available, institutions and clinicians must decide whether the use of either test is clinically justified in women with symptoms of preterm labor.…”

Section: Diagnostic Accuracy Of Phigfbp-1 Testing S Cooper Et Almentioning

confidence: 99%

Diagnostic accuracy of rapid phIGFBP-I assay for predicting preterm labor in symptomatic patients

et al. 2011

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Objective: To estimate sensitivity, specificity, positive and negative predictive values (PPV, NPV) of insulin-like growth factor binding protein-1 (phIGFBP-1) test in predicting preterm delivery in women with symptoms of preterm labor. Secondary objectives were to compare test characteristics of the phIGFBP-1 and fetal fibronectin (fFN) tests.Study Design: Labor and delivery units in two Calgary hospitals. Subjects were 349 women with suspected labor between 24 and 35 weeks gestational age (GA). Women had cervical phIGFBP-1 test þ /À and fFN testing. Sensitivity, specificity, PPV and NPV were estimated. Primary outcome was birth <37 weeks GA.Result: Sensitivity of phIGFBP-1 test for delivery <37 weeks was 0.39; specificity, 0.76; PPV, 0.24; NPV, 0.86. NPV of phIGFBP-1 did not differ greatly from that of fFN testing (0.88).Conclusion: NPV did not differ between phIGFBP-1 and fFN for delivery <37 weeks. Neither test improves on pretest probability of delivery <37 weeks, so clinicians must decide whether the use of either test is justified.

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Fetal fibronectin testing for reducing the risk of preterm birth

Cited by 153 publications

References 29 publications

Structure and factors of the risk of premature birth

Structure and factors of the risk of premature birth

The obstetric syndromes: clinical relevance of placental hormones

Diagnostic accuracy of rapid phIGFBP-I assay for predicting preterm labor in symptomatic patients

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