Poster Session III
Friday, February 15 • 10:30 AM - 12:00 PM • Octavius Ballroom • Caesars Palace
545: Quantitative fFN for prediction of spontaneous PTB in a high-risk asymptomatic population: the equate trial

https://doi.org/10.1016/j.ajog.2018.11.567Get rights and content

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Objective

To evaluate the association of second trimester cervicovaginal quantitative fetal fibronectin (qfFN) for predicting the risk of spontaneous preterm birth (sPTB) in a high-risk asymptomatic population.

Study Design

The EQUATE trial was a prospective observational study of asymptomatic patients at high risk for sPTB based on a previous sPTB, twin gestation, short cervical length (≤25 mm), and/or prior cervical surgery. The study was conducted across 16 US sites from Nov 2013 to Oct 2016. A single qfFN specimen was collected by speculum examination from each subject between 16-0/7 and 21-6/7 weeks along with demographic/clinical data and pregnancy/neonatal outcomes. Outcome measures were the rates of sPTB

Results

1,644 subjects were enrolled; 1,546 (94%) were evaluable and included in the final analysis. The overall sPTB rate was 13.4% (207/1546) <35 week and 6.2% (96/1546) <32 weeks. Within the study population, 60% stratified to the lowest fFN group of <10 ng/mL, 34% within 10-199 ng/mL, 4.7% within 200-499 ng/mL, and 1.3% to the highest group of ≥500 ng/mL. sPTB rates <35 and <32 weeks were associated with increasing concentrations of fFN in a dose-dependent fashion (Table), with similar results

Conclusion

This blinded, multicenter US study demonstrates that increasing cervicovaginal qfFN levels at 16-22 weeks were associated with an elevated risk of sPTB in a high-risk asymptomatic population, with an even greater positive association in twin pregnancies.

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