Perinatology.  2022 Dec;33(4):188-195. 10.14734/PN.2022.33.4.188.

The Association between Qualitative Fetal Fibronectin Test from Cervicovaginal Dis charge and the Presence of Histologic Chorioamnionitis in Preterm Labor with Intact Membranes

• Kim HJ
• Lee SJ
• Shin HL
• Lee HK
• Hong SB
• Kim HJ
• Park JY

• KMID: 2537723
• DOI: http://doi.org/10.14734/PN.2022.33.4.188

Abstract

Objective
To determine the predictive value of the qualitative fetal fibronectin test from cervicova ginal discharge for histologic chorioamnionitis in patients with preterm labor and intact membranes Methods: This retrospective cohort study included consecutive singleton pregnancies who had been hospitalized for uterine contractions before 37 weeks of gestation from August 2017 to May 2020. All patients underwent the qualitative fetal fibronectin test from cervicovaginal discharge, cervical length measurement by transvaginal ultrasonography, and blood test for C-reactive protein. Those who delivered at term gestation were excluded for the analysis. The primary outcome was the presence of histologic chorioamnionitis.
Results
(1) The proportion of histologic chorioamnionitis was higher in the group with positive fetal fibronectin results than that with negative results (62% vs. 18%, P<0.001); (2) The positive fetal fibro nectin was significantly associated with histologic chorioamnionitis (relative risk 4.6, 95% confidence interval 1.3-16.0, P=0.017) in multivariate logistic regression analysis even after adjustment of gesta tional age at delivery; (3) The sensitivity to predict histologic chorioamnionitis of qualitative positive fetal fibronectin test was 87%.
Conclusion
The qualitative fetal fibronectin test from cervicovaginal discharge is independently associated with the presence of histologic chorioamnionitis.

Keyword

Fibronectin; Chorioamnionitis; Premature birth; Premature labor; Cervical length