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Updated: Jun 21, 2026
19:15
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Risk predictors for preterm birth]
Roberto Eduardo Bittar1, Marcelo Zugaib
1Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo - São Paulo (SP), Brasil. roberto.bittar@hcnet.usp.br
Summary
Predicting preterm birth is challenging. Combining cervical length measurement with fetal fibronectin tests improves prediction accuracy for preterm labor in pregnant women.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Preterm birth is a leading cause of neonatal morbidity and mortality.
- Traditional clinical risk factors for preterm birth have low sensitivity and predictive value.
- Cervical changes and biochemical markers are being investigated for improved prediction.
Purpose of the Study:
- To evaluate the predictive performance of various clinical and objective measures for preterm birth.
- To assess the utility of transvaginal ultrasound cervical length and fetal fibronectin assay in predicting preterm birth.
- To determine if combining these methods enhances predictive accuracy.
Main Methods:
- Review of clinical factors associated with preterm birth.
- Measurement of cervical length using transvaginal ultrasound.
- Fetal fibronectin assay in symptomatic women.
- Analysis of sensitivity and positive/negative predictive values for each method and combined approaches.
Main Results:
- Clinical factors like prior preterm birth and vaginal bleeding have high risk but low prevalence.
- Manual cervical examination shows limited predictive value.
- Decreased cervical length on ultrasound is associated with increased preterm birth risk, offering better sensitivity than clinical factors.
- Fetal fibronectin assay is most useful for its negative predictive value in symptomatic women.
- Combining cervical length and fetal fibronectin assays reportedly increases sensitivity for preterm birth prediction.
Conclusions:
- Accurate prediction of preterm birth remains a significant clinical challenge.
- Transvaginal ultrasound for cervical length and fetal fibronectin testing offer improved, though still limited, predictive capabilities.
- Combining cervical length measurement with fetal fibronectin assay shows promise for enhancing the prediction of preterm birth, particularly in symptomatic women.
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