From the Journals

Fetal fibronectin may be underused in preterm birth detection



Only a small percentage of pregnant women with symptoms of preterm labor who are admitted to emergency departments or labor and delivery units receive fetal fibronectin testing, suggesting the test may not be fully utilized, according to results from a retrospective study.

Using data collected from the Medical Outcomes Research for Effectiveness and Economics Registry, 23,062 patients were included in the study, of whom just 12% received fetal fibronectin (fFN) testing, according to Sean C. Blackwell, MD, of the department of obstetrics, gynecology and reproductive sciences at the University of Texas, Houston, and his associates (Clinicoecon Outcomes Res. 2017 Oct 3;9:585-94. doi: 10.2147/CEOR.S141061).

The rate of fFN testing was even lower – 4.2% – among women who were discharged home but gave birth within 3 days, compared with the testing rate of 16.7% in women who were discharged and did not give birth within 3 days, which suggests “that there may be opportunities to improve the care management of these patients with the use of such screening tools as fFN testing,” the researchers wrote.

Patients who resided in the Northeast were less likely to receive fFN testing, while patients in the West were slightly more likely to receive testing. Patients with more all-cause physician visits and who had received transvaginal ultrasound also were more likely to receive fFN testing, they reported.

“Additional research is needed to determine how to use quantitative fFN testing tools currently under development as part of screening for risk of [preterm labor] allowing physicians the opportunity to better understand patient risk factors and tailor interventions to optimize pre- and perinatal care for the woman and her neonate,” Dr. Blackwell and his associates wrote.

Three of the study authors are employees of Avalere Health, which received funding from Hologic Inc., to support the study. Another author is an employee of Hologic, which produces fFN tests. The authors had no other disclosures.

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