Objective: To validate the utility of fetal fibronectin (fFN) and cervical length (CL) in predicting preterm delivery among symptomatic nulliparous women.
Methods: A retrospective cohort study of nulliparous women who presented with uterine contractions, abdominal pain, or cervical change at 21-34 gestational weeks at Fukushima Medical University Hospital, Japan, between 2008 and 2017. fFN (categorized as <50 ng/dL, 50-199 ng/dL, >200 ng/dL) and CL (≥15 mm or <15 mm) were evaluated simultaneously. Adjusted odds ratios (aORs) and confidence intervals (CIs) for preterm delivery before 37 or 34 weeks, and delivery within 28 or 14 days were calculated (references: fFN, <50 ng/dL; CL, ≥15 mm).
Result: Among 285 women who met the study criteria, CL less than 15 mm was a risk factor for preterm delivery before 37 (aOR, 4.1; 95% CI, 1.1-6.7) and 34 (aOR, 6.8; 95% CI, 2.3-20.2) weeks. fFN of 200 ng/dL or higher was a risk factor for delivery within 28 (aOR, 19.8; 95% CI, 4.3-90.2) and 14 (aOR, 10.8; 95% CI, 1.7-67.6) days.
Conclusion: Among symptomatic nulliparous women, short CL was found to be a risk factor for preterm delivery and higher fFN levels were related to short gestational latency.
Keywords: Cervical length; Fetal fibronectin; Maternal age; Nulliparous; Prediction; Preterm birth; Preterm delivery; Symptomatic.
© 2019 International Federation of Gynecology and Obstetrics.