Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Childbirth Research Associates, North Hollywood, Los Angeles, California, USA.
Sci Rep. 2019 Mar 14;9(1):4438. doi: 10.1038/s41598-019-41163-8.
Our goal was to assess whether quantitative fetal fibronectin (qfFN) is associated with spontaneous preterm birth (sPTB) after laser surgery for twin-twin transfusion syndrome (TTTS). qfFN was collected within 24 hours before and after laser surgery. Aims were: (1) To determine if qfFN changed with operative fetoscopy; and (2) To estimate the number of patients needed to study the predictive value of qfFN for sPTB <28 and <32 weeks. Results are reported as median (range). Among 49 patients, there was no net difference in qfFN levels after laser surgery [0.0 ng/mL (-37 to +400), p = 0.6041]. However, patients with a qfFN increase >10 ng/mL were 19 times more likely to undergo sPTB at <28 weeks (OR = 19.5). We determined that 383 and 160 patients would be needed to achieve adequate statistical power for qfFN to be predictive of sPTB at a GA <28 weeks and <32 weeks, respectively. In conclusion, laser surgery did not alter the qfFN level within the entire cohort, but qfFN may be useful in identifying a subset of patients at increased risk of preterm delivery.
我们的目标是评估定量胎儿纤维连接蛋白（qfFN）是否与双胎输血综合征（TTTS）激光手术后自发性早产（sPTB）有关。qfFN 在激光手术前后 24 小时内采集。目的是：（1）确定 qfFN 是否随手术内窥镜检查而变化；（2）估计需要多少患者来研究 qfFN 对 sPTB<28 周和 sPTB<32 周的预测价值。结果以中位数（范围）报告。在 49 名患者中，激光手术后 qfFN 水平没有净差异[0.0ng/mL（-37 至+400），p=0.6041]。然而，qfFN 增加>10ng/mL 的患者发生 sPTB<28 周的可能性增加 19 倍（OR=19.5）。我们确定，需要 383 名和 160 名患者才能分别获得足够的统计效力，以使 qfFN 对 sPTB<28 周和 sPTB<32 周具有预测价值。总之，激光手术并未改变整个队列的 qfFN 水平，但 qfFN 可能有助于识别早产风险增加的亚组患者。
