Fox Nathan S, Rebarber Andrei, Roman Ashley S, Klauser Chad K, Peress Danielle, Saltzman Daniel H
Maternal Fetal Medicine Associates, PLLC, New York, NY 10128, USA.
J Matern Fetal Neonatal Med. 2012 Nov;25(11):2308-11. doi: 10.3109/14767058.2012.691579. Epub 2012 May 23.
To estimate the association between fetal fibronectin (fFN), cervical length (CL), and spontaneous preterm birth (SPTB) in asymptomatic women with triplet pregnancies.
A cohort of 39 consecutive women with triplet pregnancies managed in one Maternal-Fetal medicine practice from 2005-2011 was analyzed. Combined fFN and CL testing was performed every 2 weeks from 22-32 weeks. A short CL was defined as ≤ 20 mm.
A positive fFN was significantly associated with SPTB <28 weeks, <30 weeks, <32 weeks, and <34 weeks. A short CL was significantly associated with SPTB <32 weeks. On combined testing, having both tests positive was associated with the highest likelihood of SPTB at all gestational ages. As a screening test for SPTB <32 weeks, having both a positive fFN and a short CL had a sensitivity of 62.5%, specificity of 90%, positive predictive value of 62.5%, negative predictive value of 90%, positive likelihood ration of 2.98 and negative likelihood ratio of 0.88. Combined fFN and CL outperformed fFN alone, CL alone, or either test being positive alone.
In asymptomatic women with triplet pregnancies, fFN and CL are each significantly associated with SPTB. For the prediction of SPTB, combined fFN and CL testing outperforms either test alone.
评估无症状三胎妊娠女性中胎儿纤连蛋白（fFN）、宫颈长度（CL）与自发性早产（SPTB）之间的关联。
分析了2005年至2011年在一家母胎医学诊所管理的39例连续三胎妊娠女性队列。从22至32周，每2周进行一次fFN和CL联合检测。短宫颈定义为≤20毫米。
fFN阳性与28周前、30周前、32周前和34周前的SPTB显著相关。短宫颈与32周前的SPTB显著相关。联合检测时，两项检测均为阳性与所有孕周的SPTB可能性最高相关。作为32周前SPTB的筛查试验，fFN阳性且宫颈短的敏感性为62.5%，特异性为90%，阳性预测值为62.5%，阴性预测值为90%，阳性似然比为2.98，阴性似然比为0.88。fFN和CL联合检测优于单独的fFN检测、单独的CL检测或任何一项检测单独呈阳性。
在无症状三胎妊娠女性中，fFN和CL均与SPTB显著相关。对于SPTB的预测，fFN和CL联合检测优于单独的任何一项检测。
