|November 2003 · Vol. 15, No. 11
Is routine sampling of fetal fibronectin justified?
This test does help identify women likely to deliver early. To warrant universal use, however, a screening test should meet 5 conditions—including availability of an effective intervention.
Dr. Macones is associate professor of obstetrics, gynecology, and epidemiology; director, division of maternal-fetal medicine; and director, obstetrics, University of Pennsylvania Health System, Philadelphia. Dr. Cahill is an instructor, department of obstetrics and gynecology, University of Pennsylvania Health System, Philadelphia.
Spontaneous preterm birth is associated with elevated cervicovaginal fetal fibronectin levels, especially in women who deliver at an early gestational age.
A recent study suggests that antibiotic therapy in women with a positive fetal fibronectin screening test does not reduce the incidence of spontaneous preterm birth or improve neonatal outcomes.
Fetal fibronectin cannot be recommended as a screening test for preterm birth.
Routine fetal fibronectin sampling to identify women at risk for preterm delivery seems justified, studies suggest. Closer scrutiny, however, reveals the absence of an element crucial to successful screening: an effective intervention.
This article reviews the landmark studies of fetal fibronectin testing, as well as findings of a recent multicenter double-blind, place-bo-controlled trial of antibiotic therapy.