Cervicovaginal Fetal Fibronectin Levels in Preterm Labor: Just Association or Reliable Screening Biomarker

Abstract

Background: Preterm birth (PTB) is a chief reason for neonatal illness and death. Prediction of PTB can prevent complications. The cervico-vaginal fetal fibronectin (fFN) test is a good predictor for preterm labor (PTL) within 7 to 14 days from testing. The levels of fFN are high during the first 16 to 22 weeks of gestation in normal pregnancy before it drops to very low values and rises over again as the gestation reaches term. The current work aimed to assess the association and reliability of cervicovaginal fFN in predicting PTL. Patient and method: The study was cross-sectional that included hundred pregnant (aging from 20–34 years), gestational age ranging (from 24–34 weeks), and presented with abdominal pain. All applicants’ Detailed medical history regarding age, gravidity, and parity were taken from all applicants. Gestational age was calculated through general examination and abdominal and vaginal examination. During speculum vaginal examination, fFN samples were taken from the cervix and were examined for fFN using the quick check for assay. Statistical scrutiny was carried out by SPSS version 17. A p ≤ 0.05 was measured as significant. Result: The mean age was (27.53 ± 4.23), range (of 20–34). Positive fFN results were detected in only (22%) of patients. Around two-thirds of the women end their pregnancy by normal vaginal delivery. Less than half (45.5%) of the included women delivered within one week after presentation, around 1/3rd (31.8%) delivered after the second week, and only 22.2% delivered during the first day of presentation. There was a significant association between pregnancy outcome and fFN results. A majority (90.9%) of patients end with preterm labor during 2 weeks of follow-up were presented with positive fetal fibronectin. The majority (90.9%) of patients end with preterm labor during 2 weeks of follow-up were presented with positive fFN results. There were non-significant variations between means of gestational ages, parity, and gestational age/weeks between those with positive and negative fFN results. Conclusion: Among pregnant women with uterine contraction before advanced cervical dilatation, the presence of cervicovaginal fFN is an associated and reliable screening test in predicting the risk of PTL.