The Significance of a Positive Fetal Fibronectin in the Setting of a Normal Cervical Length in Twin Pregnancies.

Autor:	Fox, Nathan S., Rebarber, Andrei, Roman, Ashley S., Klauser, Chad K., Saltzman, Daniel H.
Předmět:	RISK factors in premature labor CERVIX uteri CHI-squared test COMPUTER software CONFIDENCE intervals EPIDEMIOLOGY FETAL ultrasonic imaging FIBRONECTINS FISHER exact test IMMUNOASSAY EVALUATION of medical care T-test (Statistics) TWINS U-statistics DATA analysis MULTIPLE regression analysis RETROSPECTIVE studies FETUS PREGNANCY
Zdroj:	American Journal of Perinatology; 2011, Vol. 28 Issue 9, p1-6, 6p, 5 Charts
Abstrakt:	To estimate the risk of preterm birth in asymptomatic women with twin pregnancies with a normal cervical length (CL) and a positive fetal fibronectin (fFN), we reviewed a retrospective cohort of twin pregnancies delivered in our practice from 2005 to 2010. Patients were screened from 22 to 32 weeks with CL and fFN at 2- to 4-week intervals. We examined 244 patients with twin pregnancies and a normal CL (>25 mm) between 22 and 32 weeks and compared outcomes based on the fFN result. Fourteen (5.7%) patients had a positive fFN and 230 (94.3%) patients had a negative fFN. Positive fFN was associated with an increased the risk of spontaneous preterm birth <37 weeks (85.7% versus 38.3%, p=0.001), <35 weeks (50% versus 11.8%, p <0.001), <34 weeks (35.7% versus 6.9%, p <0.001), and <32 weeks (21.4% versus 2.2%, p <0.001). On adjusted analysis, a positive fFN was independently associated with preterm birth <32 weeks (odds ratio 6.8, 95% confidence interval 1.42, 32.2) and gestational age at delivery (p=0.001). In the setting of a normal CL, a positive fFN is significantly associated with preterm birth in asymptomatic twin pregnancies. Contingency model screening of fFN in asymptomatic twin pregnancies solely based on CL evaluation may fail to identify a cohort of at-risk patients. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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