Roman Ashley S, Pessel Cara, Fox Nathan, Klauser Chad K, Saltzman Daniel, Rebarber Andrei
Maternal-Fetal Medicine Associates, PLLC, New York, NY , USA.
J Matern Fetal Neonatal Med. 2012 Oct;25(10):1921-3. doi: 10.3109/14767058.2012.677964. Epub 2012 Apr 28.
To assess the diagnostic accuracy of vaginal fetal fibronectin (fFN) sampling for predicting preterm birth in asymptomatic women carrying triplet gestations.
An historical cohort of patients carrying triplet gestations between 1998 and 2010 was identified from a single practice by chart review. All patients were screened with fFN testing at 2-3 week intervals from 22 weeks to 32 weeks of gestation. Outcomes evaluated were spontaneous preterm birth prior to 28, 30, and 32 weeks' gestation and delivery within 2 and 3 weeks of testing.
There were 56 pregnancies that met criteria for inclusion. For delivery prior to 30 weeks' gestation, the test had a sensitivity of 75%, a specificity of 85.4%, a positive predictive value of 46.2%, a negative predictive value of 95.3%, positive likelihood ratio of 5.13, and a negative likelihood ratio of 0.29 (p < 0.0001). For delivery within 3 weeks of a single fFN assessment, the test had a sensitivity of 53.3%, a specificity of 95.8%, a positive predictive value of 53.3%, a negative predictive value of 95.8%, positive likelihood ratio of 12.7 and negative likelihood ratio of 0.48 (p < 0.0001).
Fetal fibronectin testing provides moderate to high prediction of spontaneous preterm birth in triplet gestations.
评估阴道胎儿纤连蛋白（fFN）取样对预测无症状三胎妊娠妇女早产的诊断准确性。
通过病历审查，从单一医疗机构中确定了1998年至2010年间三胎妊娠患者的历史队列。所有患者在妊娠22周-32周期间，每隔2-3周接受fFN检测。评估的结局包括妊娠28、30和32周前的自发早产以及检测后2周和3周内的分娩情况。
有56例妊娠符合纳入标准。对于30周前分娩，该检测的敏感性为75%，特异性为85.4%，阳性预测值为46.2%，阴性预测值为95.3%，阳性似然比为5.13，阴性似然比为0.29（p<0.0001）。对于单次fFN评估后3周内分娩，该检测的敏感性为53.3%，特异性为95.8%，阳性预测值为53.3%，阴性预测值为95.8%，阳性似然比为12.7，阴性似然比为0.48（p<0.0001）。
胎儿纤连蛋白检测对三胎妊娠自发早产具有中度至高预测性。
