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[Prediction of prematurity by oncofetal fibronectin. Prospective cohort study]
1Département de Gynécologie et d'Obstétrique, Hôpital Cantonal Universitaire de Genève, Suisse.
Objective:
To evaluate the association between cervical oncofoetal fibronectin and prematurity as well as the interval between sampling and delivery in symptomatic women.
Methods:
Cervical fibronectin was measured with an immunoassay in a cohort of 64 women at the University Hospital of Geneva. Subjects with positive and negative fibronectin were then compared using the relative risk and the incidence rate ratio of premature delivery as well as the survival tables. Performance of the test to predict premature delivery or delivery within one week of the test were expressed in terms of sensitivity, specificity, predictive values and likelihood ratios with their 95% confidence intervals.
Results:
Thirty-four percent of women delivered prematurely. The presence of fibronectin was significantly associated with premature delivery and with a shorter interval to delivery. The likelihood ratio for a positive test was 2.6(95% CI: 1.45-4.66). A negative test had a 100% predictive value to exclude delivery within one week of the test.
Conclusion:
Oncofoetal fibronectin appears to be the best marker currently available to predict premature delivery. A randomized trial is needed to confirm its clinical usefulness.