Feinberg School of Medicine, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, 250 E. Superior St, Suite 05-2175, Chicago, IL.
Feinberg School of Medicine, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, 250 E. Superior St, Suite 05-2175, Chicago, IL.
Semin Perinatol. 2017 Dec;41(8):445-451. doi: 10.1053/j.semperi.2017.08.002. Epub 2017 Sep 19.
Spontaneous preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, and accounts for a significant global health burden. Several obstetric strategies to screen for spontaneous preterm delivery, such as cervical length and fetal fibronectin measurement, have emerged. However, the effectiveness of these strategies relies on their ability to accurately predict those pregnancies at increased risk for spontaneous preterm birth (SPTB). Transvaginal cervical shortening is predictive of preterm birth and when coupled with appropriate preterm birth prevention strategies, has been associated with reductions in SPTB in asymptomatic women with a singleton gestation. The use of qualitative fetal fibronectin may be useful in conjunction with cervical length assessment in women with acute preterm labor symptoms, but data supporting its clinical utility remain limited. As both cervical length and qualitative fetal fibronectin have limited capacity to predict preterm birth, further studies are needed to investigate other potential screening modalities.
自发性早产仍然是全球新生儿发病率和死亡率的主要原因，也是全球重大的健康负担。目前已经出现了几种用于筛查自发性早产的产科策略，如宫颈长度和胎儿纤维连接蛋白检测。然而，这些策略的有效性取决于其准确预测那些具有自发性早产风险增加的妊娠的能力。经阴道宫颈缩短可预测早产，当与适当的早产预防策略相结合时，已与无症状单胎妊娠妇女的自发性早产减少相关。定性胎儿纤维连接蛋白的使用可能在伴有急性早产症状的妇女的宫颈长度评估中有用，但支持其临床实用性的数据仍然有限。由于宫颈长度和定性胎儿纤维连接蛋白预测早产的能力均有限，因此需要进一步研究以探讨其他潜在的筛查方式。
