Risk scoring, fetal fibronectin, and bacterial vaginosis to predict preterm delivery

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Spontaneous preterm birth (SPB) is a leading cause of neonatal morbidity and mortality.
• Accurate prediction of SPB is crucial for timely intervention and improved outcomes.
• Current predictive markers have limited accuracy, necessitating the exploration of novel combinations.

Purpose of the Study:

• To evaluate the predictive value of various markers, including risk scores and fetal fibronectin variants, for spontaneous preterm birth.
• To identify independent predictors and optimal combinations for predicting SPB in asymptomatic pregnant individuals.

Main Methods:

• Recruitment of 140 asymptomatic gravidas between 20-24 weeks' gestation.
• Assessment of preterm birth-risk score and analysis of vaginal swabs for bacterial vaginosis and fetal fibronectin variants (FDC-6, X18A4, CAF).
• Application of univariate and multiple logistic regression analyses, with calculation of sensitivity, specificity, and predictive values.

Main Results:

• Preterm birth-risk score and vaginal fetal fibronectin FDC-6 were significant predictors of SPB (OR 16.9 and 8.0, respectively).
• Bacterial vaginosis and other fibronectin variants showed no significant association with SPB in this cohort.
• The combination of a positive risk score and vaginal fetal fibronectin FDC-6 demonstrated high specificity (97.7%) and a positive likelihood ratio of 19.4.

Conclusions:

• The combination of preterm birth-risk score and vaginal fetal fibronectin FDC-6 shows promise in predicting spontaneous preterm birth.
• Further intervention trials are warranted to ascertain if this combined screening approach can effectively reduce SPB rates.