Mouw R J, Egberts J, Kragt H, van Roosmalen J
Department of Obstetrics, Leiden University Medical Centre, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1998 Sep;80(1):67-70. doi: 10.1016/s0301-2115(98)00088-8.
To determine the predictive value of cervicovaginal fetal fibronectin (fFN) concentrations > or =50 ng/ml for spontaneous onset of labour within 3 days in pregnancies of 41 weeks gestation or more.
In the Department of Obstetrics, Leiden University Medical Centre, and of the Diaconessen Hospital, Voorburg (The Netherlands), 126 cervicovaginal secretions of fFN, from 80 consenting women between 287 and 304 days gestation were collected. Pregnant women underwent sterile speculum examinations for cervicovaginal sampling from the 41st week onwards. The fFN concentration in these samples was determined with a quantitative solid-phase enzyme-linked immunosorbent assay. Concentrations of <50 ng fFN per ml were characterised as negative test results, meaning that spontaneous delivery would not take place within 3 days, and those of > or =50 fFN ng/ml were taken as positive test results. Sensitivity and specificity of the fFN test were calculated for predicting spontaneous birth. Parametric and nonparametric tests were used for evaluating differences and correlations.
Spontaneous delivery took place after 2.5+/-2.5(SD) days with fFN values > or =50 ng/ml and after 4.7+/-3.6 days with fFN concentrations <50 ng/ml (P<0.001). Sensitivity and specificity of the fFN test predicting spontaneous onset of labour within 3 days, were 0.71 [95% confidence interval (CI) 0.58-0.86] and 0.64 (95% CI 0.48-0.78). If fFN > or =50 ng/ml then a spontaneous onset of labour is more likely to occur within 3 days (odds ratio 4.5 (95% CI 1.8-11.3).
The fFN test does not predict accurately enough whether or not birth will take place within 3 days of sampling. Nevertheless, the higher odds for spontaneous delivery within a few days when the test is positive may be of use in planning adjusted induction of labour.
确定宫颈阴道胎儿纤维连接蛋白（fFN）浓度≥50 ng/ml对妊娠41周及以上孕妇在3天内自然发动分娩的预测价值。
在荷兰莱顿大学医学中心妇产科和福尔堡迪亚科内森医院，收集了80名妊娠287至304天且同意参与研究的孕妇的126份宫颈阴道fFN分泌物样本。从第41周起，孕妇接受无菌阴道镜检查以采集宫颈阴道样本。采用定量固相酶联免疫吸附测定法测定这些样本中的fFN浓度。每毫升fFN浓度<50 ng被视为阴性检测结果，意味着3天内不会自然分娩；≥50 ng/ml则被视为阳性检测结果。计算fFN检测预测自然分娩的敏感性和特异性。使用参数检验和非参数检验来评估差异和相关性。
fFN值≥50 ng/ml的孕妇在2.5±2.5（标准差）天后自然分娩，fFN浓度<50 ng/ml的孕妇在4.7±3.6天后自然分娩（P<0.001）。fFN检测预测3天内自然发动分娩的敏感性和特异性分别为0.71[95%置信区间（CI）0.58 - 0.86]和0.64（95% CI 0.48 - 0.78）。如果fFN≥50 ng/ml，那么在3天内更有可能自然发动分娩（优势比4.5（95% CI 1.8 - 11.3））。
fFN检测对于采样后3天内是否会分娩的预测不够准确。然而，检测呈阳性时在几天内自然分娩的较高几率可能有助于计划调整引产。
