Abstract

Aim: To evaluate the roles of increased levels of fibronectin in vaginal fluid for prediction of preterm delivery Methods: Fibronectin levels of cervicovaginal fluid were measured in 73 consecutive pregnant women aged 24-34 weeks of gestation. It was analyzed whether the level of fibronectin had predictive properties for preterm delivery. Results: Of the 73 pregnant women, 19 delivered preterm (26%) and 54 delivered at term (74%). For predicting preterm birth, cut-off values were determined using ROC (Receive Operating Characteristic Curve) curves and corresponding values. Cut-off value of fibronectin was determined to be 61.5 ng / mL and the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100%, 92.6%, 82.6% and 100% , respectively. Conclusion: The study support the fibronectin in vaginal fluid can be used for predict of preterm delivery in pregnant women at 24-34 weeks of gestation.

Keywords

• preterm birth,pregnancy,fibronectin

Cervico-Vaginal Fibronectin in Prediction of Preterm Delivery

Abstract

Amaç: Preterm doğumun öngörüsünde vajinal sıvıdaki artmış fibronektin düzeylerinin rolünü değerlendirmek Gereç ve Yöntem: Servikovajinal yıkama sıvısında fibronektin düzeyleri 24-34. haftalar arasında olan 73 ardışık gebede ölçüldü. Fibronektin düzeyinin preterm doğum için prediktif özelliklere sahip olup olmadığı analiz edildi. Bulgular: 73 gebe kadından 19'u (% 26) preterm ve 54'ü (% 74) miadında doğum yaptı. Erken doğumu öngörmede için, cutt-off değerleri ROC (Receive Operating Characteristic Curve) eğrileri ve karşılık gelen değerler kullanılarak belirlendi. Fibronektin için cut-off değeri 61.5 ng / mL olarak belirlendi ve duyarlılık, özgüllük, pozitif kestirim değeri (PPV) ve negatif kestirim değeri (NPV) sırasıyla% 100,% 92,6,% 82,6 ve% 100 idi. Sonuç: 24-34. haftalardaki gebe kadınlarda serviko-vajinal sıvıdaki fibronektin, preterm doğumu öngörmede kullanılabilir.

Keywords

• erken doğum,fibronektin,gebelik

References

1. 1. Spong CY. Defining “term” pregnancy: Recommendations from the defining “term” pregnancy workgroup. Vol. 68, Obstetrical and Gynecological Survey. 2013. p. 611–2.
2. 2. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Vol. 371, The Lancet. 2008. p. 75–84.
3. 3. Slattery MM, Morrison JJ. Preterm delivery. Vol. 360, Lancet. 2002. p. 1489–97.
4. 4. Simhan HN, Caritis SN. Prevention of preterm delivery. N Engl J Med. 2007;357(5):477–87.
5. 5. Slattery MM, Morrison JJ. Preterm delivery. Lancet. 2015;360(9344):1489–97.
6. 6. Iams JD. Care for Women with Prior Preterm Birth. In: Preterm Birth: Prevention and Management. 2010. p. 115–29.
7. 7. Hodgson EJ, Lockwood CJ. Preterm Birth: Prevention and Management - Google Books. Preterm Birth Prev {…}. 2010;
8. 8. Esplin MS, Elovitz MA, Iams JD, Parker CB, Wapner RJ, Grobman WA, et al. Predictive accuracy of serial transvaginal cervical lengths and quantitative vaginal fetal fibronectin levels for spontaneous preterm birth among nulliparous women. JAMA - J Am Med Assoc. 2017;317(10):1047–56.

9. 9. Ananth C V., Joseph KS, Oyelese Y, Vintzileos AM. Trends in preterm birth and perinatal mortality among singletons: united states, 1989 through 2000. Obstet Gynecol. 2005;105(5):1084–91.
10. 10. Movahedi M, Saiedi M, Gharipour M, Aghadavoudi O. Diagnostic performance and discriminative value of the serum ferritin level for predicting preterm labor. J Res Med Sci. 2012;17(2):164–6.
11. 11. Broumand F, Saeidkar S, Behrouzlak T, Khalkhali H, Sadeghi-Bazargani H. The diagnostic value of cervicovaginal and serum ferritin levels in midgestation time to predict spontaneous preterm delivery. Niger Med J. 2014;55(4):321–6.
12. 12. Marvin KW, Keelan JA, Coleman MA, McCowan LM, Zhou RL, Mitchell MD. Intercellular adhesion molecule-1 (ICAM-1) in cervicovaginal fluid of women presenting with preterm labor: predictive value for preterm delivery. Am J Reprod Immunol. 2000;43(5):264–71.
13. 13. Sunagawa S, Takagi K, Ono K, Miyachi K, Kikuchi A. Comparison of biochemical markers and cervical length for predicting preterm delivery. J Obstet Gynaecol Res. 2008;34(5):812–9.
14. 14. Adhikari K, Bagga R, Suri V, Arora S, Masih S. Cervicovaginal HCG and cervical length for prediction of preterm delivery in asymptomatic women at high risk for preterm delivery. Arch Gynecol Obstet. 2009;280(4):565–72.
15. 15. Guvenal T, Kantas E, Erselcan T, Culhaoglu Y, Cetin A. Beta-human chorionic gonadotropin and prolactin assays in cervicovaginal secretions as a predictor of preterm delivery. Int J Gynecol Obstet. 2001;75(3):229–34.
16. 16. Jung EY, Park JW, Ryu A, Lee SY, Cho SH, Park KH. Prediction of impending preterm delivery based on sonographic cervical length and different cytokine levels in cervicovaginal fluid in preterm labor. J Obstet Gynaecol Res. 2016;42(2):158–65.
17. 17. Honest H, Forbes CA, Durée KH, Norman G, Duffy SB, Tsourapas A, et al. Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling. Vol. 13, Health technology assessment (Winchester, England). 2009. p. 1–627.
18. 18. Kalinka J, Sobala W, Wasiela M, Brzezińska-Błaszczyk E. Decreased proinflammatory cytokines in cervicovaginal fluid, as measured by midgestation, are associated with preterm delivery. Am J Reprod Immunol. 2005;54(2):70–6.
19. 19. Nikolova T, Bayev O, Nikolova N, Di Renzo GC. Evaluation of a novel placental alpha microglobulin-1 (PAMG-1) test to predict spontaneous preterm delivery. J Perinat Med. 2014;42(4):473–7.
20. 20. Tsiartas P, Holst RM, Wennerholm UB, Hagberg H, Hougaard DM, Skogstrand K, et al. Prediction of spontaneous preterm delivery in women with threatened preterm labour: a prospective cohort study of multiple proteins in maternal serum. BJOG. 2012;119(7):866–73.
21. 21. Kim M-A, Lee BS, Park Y-W, Seo K. Serum markers for prediction of spontaneous preterm delivery in preterm labour. Eur J Clin Invest. 2011;41(7):773–80.
22. 22. Hirschi SD, Gray SD, Thibeault SL. Fibronectin. J Voice. 2002;16(3):310–6.
23. 23. Leitich H, Kaider A. Fetal fibronectin--how useful is it in the prediction of preterm birth? Bjog. 2003;110 Suppl:66–70.
24. 24. Lucaroni F, Morciano L, Rizzo G, D’ Antonio F, Buonuomo E, Palombi L, et al. Biomarkers for predicting spontaneous preterm birth: an umbrella systematic review. J Matern Neonatal Med. 2017;1–9.
25. 25. Goepfert AR, Goldenberg RL, Mercer B, Iams J, Meis P, Moawad A, et al. The preterm prediction study: Quantitative fetal fibronectin values and the prediction of spontaneous preterm birth. Am J Obstet Gynecol. 2000;183(6):1480–3.