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    The Quest for the Ideal Tests to Predict Preterm Births


    There is one possible exception, he says. A negative result from a test for fetal fibronectin is a strong indicator of a low risk of preterm birth, which could certainly change how a pregnant woman's doctor manages her care and whether she would be managed in or out of the hospital. Goldenberg is a professor of obstetrics and gynecology at the University of Alabama School of Medicine, in Birmingham. He made his presentations on behalf of the Maternal Fetal Medicine Unit Network of the NICHD.

    Goldberg's study sample was based on a healthy group of almost 3,000 pregnant women with no symptoms of preterm birth. The investigators then compared women who had a spontaneous preterm birth (SPB) before 32 weeks and before 35 weeks to this group. The goal was to check the ability of a single test or combination of tests to predict SPBs. The tests were administered during the 22nd to 24th weeks of pregnancy. Analysis of the data revealed significant associations between SPB at both 32 weeks and 35 weeks, with an array of warning signs such as a positive fetal fibronectin test, short cervical length of the mother, and blood levels of other chemical factors.

    The researchers found a low effectiveness of individual tests to predict SPB, but when multiple tests were used, the sum was greater than the parts. This indicates that the tests generally provide additive information with respect to each other, and that developing a test combining multiple markers for SPB is feasible.

    He also said there is a need for further studies of several different combinations of tests to determine their predictive value. These combined tests are not being used in doctors' practices at this time. Until there is a test that can be done in the office or hospital to predict preterm birth, it is generally recommended that pregnant women report to their doctors any preterm discomfort or hardening of the uterus or abdomen, uterine cramping, back ache, thigh ache, and vaginal discharge or bleeding.

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