King's College London

Research portal

Quantitative fetal fibronectin for prediction of preterm birth in asymptomatic twin pregnancy

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)1191-1197
Number of pages7
JournalActa Obstetricia et Gynecologica Scandinavica
Issue number9
Early online date6 Apr 2020
E-pub ahead of print6 Apr 2020
Published1 Sep 2020

Bibliographical note

This article is protected by copyright. All rights reserved.


  • Kuhrt_2020_qfFN+PREM_in_twin_pregnancies

    Kuhrt_2020_qfFN_PREM_in_twin_pregnancies.pdf, 7.17 MB, application/pdf

    Uploaded date:14 Apr 2020

    Version:Accepted author manuscript

    This article is protected by copyright. All rights reserved

King's Authors


Introduction: To evaluate cervicovaginal fluid quantitative fetal fibronectin, measured by a bedside analyzer, to predict spontaneous preterm birth in twin pregnancy before 30 weeks of gestation. Material and methods: In a prospective cohort study, we studied the accuracy of quantitative fetal fibronectin measured between 18 and 27 +6 weeks of gestation in high-risk asymptomatic women with twin pregnancies, to predict spontaneous preterm birth before 30 weeks of gestation. Predefined fetal fibronectin thresholds were ≥10, ≥50 and ≥200 ng/mL. Predictive statistics were also calculated to evaluate accuracy of “early” tests, performed between 18 and 21 +6 weeks and “standard” tests performed between 22 +0 and 27 +6 weeks of gestation in the same cohort. Subgroup analysis was performed according to cervical length measurement. In addition, we compared accuracy of prediction with quantitative fetal fibronectin measured during the standard test period in asymptomatic twin pregnancy with no additional risk factors, to twin pregnancies with one or more additional risk factors for spontaneous preterm birth. Results: Of 130 eligible women identified with quantitative fetal fibronectin tests undertaken during the standard testing period, 9% delivered before 30 weeks of gestation. Quantitative fetal fibronectin was significantly related to outcome before 30/40 (ROC curves of 0.8 [95% CI 0.7-1]). Early tests were not significantly predictive; ROC area 0.53 (95% CI 0.29-0.81). There was a trend towards better predictive accuracy when one or more additional risk factors for spontaneous preterm birth or cervical length were considered. Conclusions: Quantitative fetal fibronectin measured from 22 to 27 +6 weeks of gestation accurately predicts spontaneous preterm birth at <30 weeks of gestation. Tests undertaken earlier are of limited value. Consideration of cervical length or prior history in addition to quantitative fetal fibronectin strengthens prediction.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454