Obstetrics Department, Dubbo Base Hospital, Western New South Wales Local Health District, Dubbo, New South Wales, Australia.
Obstetrics Department, Caboolture Hospital, Queensland Health, Caboolture, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2021 Dec;61(6):905-909. doi: 10.1111/ajo.13401. Epub 2021 Jun 30.
Many women living in rural and remote Australia are required to travel large distances to birth in a hospital with maternity facilities, incurring considerable financial, social and emotional burden for them and their families. No studies to date have investigated the use of quantitative fetal fibronectin (qfFN) to predict term labour in asymptomatic pregnant women. A tool which is able to more accurately predict term labour has the potential to guide informed travel decision-making for women and healthcare professionals in rural and remote Australia.
The aim of this study is to determine if qfFN can reliably predict term labour in asymptomatic women from rural and remote areas.
Thirty-nine women from rural Australia provided 71 fFN samples between June 2016 and October 2018, from 37 weeks' gestation, with at least one week between samples for those providing multiple samples. Days from fFN sampling until spontaneous onset of labour were recorded. Using generalised estimating equation modelling we examined the utility of fFN as a predictor for onset of labour at term after adjusting for confounders.
There was a small-to-moderate negative correlation (r -0.27, P < 0.05) between time until labour and fFN. Quantitative fFN was observed to be a significant predictor of time until labour after adjusting for confounding variables (P < 0.001).
fFN levels may play a role in predicting term labour in rural women; however, future studies with a larger sample size are required to validate the findings of our pilot study.
许多居住在澳大利亚农村和偏远地区的女性需要长途跋涉前往拥有产科设施的医院分娩，这给她们及其家人带来了巨大的经济、社会和情感负担。迄今为止，尚无研究调查定量胎儿纤维连接蛋白（qfFN）在预测无症状孕妇足月分娩中的应用。一种能够更准确预测足月分娩的工具有可能指导澳大利亚农村和偏远地区的女性及其医疗保健专业人员做出明智的出行决策。
本研究旨在确定 qfFN 是否可以可靠地预测来自农村和偏远地区的无症状女性的足月分娩。
2016 年 6 月至 2018 年 10 月，39 名来自澳大利亚农村的女性提供了 71 份 fFN 样本，采集时间为 37 周妊娠，对于提供多个样本的女性，两次采样之间至少间隔一周。记录从 fFN 采样到自然分娩开始的天数。我们使用广义估计方程模型，在调整混杂因素后，研究了 fFN 作为预测足月分娩的工具的效用。
从分娩开始到 fFN 的时间与 fFN 之间存在小到中度的负相关（r=-0.27，P<0.05）。在调整混杂变量后，fFN 被观察到是分娩时间的显著预测因素（P<0.001）。
fFN 水平可能在预测农村女性足月分娩中起作用；然而，需要更大样本量的未来研究来验证我们的初步研究结果。
