TY - JOUR
T1 - Examining the relationship between positive mid-gestational fetal fibronectin assays and histological evidence of acute placental inflammation
AU - Akers, Aletha
AU - Jarzembowski, Jason A.
AU - Johnson, Clark T.
AU - Lieberman, Richard W.
AU - Dalton, Vanessa K.
PY - 2007/2/1
Y1 - 2007/2/1
N2 - Aims: Both acute placental inflammation and positive mid-gestational cervico-vaginal fetal fibronectin assays have been independently correlated with preterm delivery. We conducted this study to examine the relationship between positive mid-gestational fetal fibronectin (fFN) assays and histological evidence of acute placental inflammation at delivery among women presenting with symptomatic preterm labor. Methods: This retrospective chart review included women who underwent cervico-vaginal fFN testing for preterm contractions between 24-34 weeks gestation and also had placental histological analysis after delivery. Women with a multiple gestation, cerclage, preterm premature rupture of membranes, intercourse or vaginal bleeding within 24 h before the assay were excluded. The primary outcome was histological evidence of acute placental inflammation defined as acute chorioamnionitis, acute deciduitis, funisitis, or microabscess formation. Results: Of 82 women who met all study inclusion criteria, 45% were fFN positive. Women with positive assays were no more likely to have histological evidence of acute inflammation noted at birth than women with negative assays (45% vs. 26%, P=0.07). The assay had a sensitivity of 58.6%, specificity of 62.3%, positive predictive value of 46.0%, and negative predictive value of 73.3% for predicting acute inflammation at delivery. Conclusions: No association exists between positive fetal fibronectin assays and acute histologic placental inflammation at birth.
AB - Aims: Both acute placental inflammation and positive mid-gestational cervico-vaginal fetal fibronectin assays have been independently correlated with preterm delivery. We conducted this study to examine the relationship between positive mid-gestational fetal fibronectin (fFN) assays and histological evidence of acute placental inflammation at delivery among women presenting with symptomatic preterm labor. Methods: This retrospective chart review included women who underwent cervico-vaginal fFN testing for preterm contractions between 24-34 weeks gestation and also had placental histological analysis after delivery. Women with a multiple gestation, cerclage, preterm premature rupture of membranes, intercourse or vaginal bleeding within 24 h before the assay were excluded. The primary outcome was histological evidence of acute placental inflammation defined as acute chorioamnionitis, acute deciduitis, funisitis, or microabscess formation. Results: Of 82 women who met all study inclusion criteria, 45% were fFN positive. Women with positive assays were no more likely to have histological evidence of acute inflammation noted at birth than women with negative assays (45% vs. 26%, P=0.07). The assay had a sensitivity of 58.6%, specificity of 62.3%, positive predictive value of 46.0%, and negative predictive value of 73.3% for predicting acute inflammation at delivery. Conclusions: No association exists between positive fetal fibronectin assays and acute histologic placental inflammation at birth.
KW - Chorioamnionitis
KW - Fetal fibronectin
KW - Infection
KW - Placenta
KW - Preterm birth
UR - http://www.scopus.com/inward/record.url?scp=33847212443&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33847212443&partnerID=8YFLogxK
U2 - 10.1515/JPM.2007.005
DO - 10.1515/JPM.2007.005
M3 - Review article
C2 - 17313308
AN - SCOPUS:33847212443
SN - 0300-5577
VL - 35
SP - 36
EP - 42
JO - Journal of Perinatal Medicine
JF - Journal of Perinatal Medicine
IS - 1
ER -