Am I at Risk for Preterm Labor?
About 12% of all births today occur before the baby is ready. In fact, statistics show that many of these babies can have long-term complications and may need to remain in the NICU for days or weeks. Prematurity is also the number one cause of newborn death.
Preventing preterm labor and identifying mothers at risk are both at the top of the list for researchers, medical care providers and parents alike.
Known Risk Factors for Preterm Labor
Experts have identified a number of conditions or factors that can make it more likely for you to have preterm labor. These include:
- A previous history of preterm labor
- Pregnancy with multiples
- High blood pressure
- Mothers with a short cervix
- Smoking
- Alcohol use
- Lack of support from family/friends
- Mothers who are African-American by race
The good news is that we not only have risk factors to indicate if a mother is at risk for preterm labor, but now there is a reliable test that can identify if you are more or less likely to go into preterm labor.
Detecting Preterm Labor with Fetal Fibronectin Testing
A relatively new test, called the fetal fibronectin (fFN) is now used by many care providers to determine a mother’s risk for preterm labor.
Fetal fibronectin is a protein that attaches the amniotic sac to the lining of the mother’s uterus. It acts like a “glue” and is often found in the mother’s vaginal discharge from early pregnancy until about 22 weeks of pregnancy. After 5 1/2 months, fFN is typically no longer present until 1-3 weeks before your due date.
If fFN test is done between 22 and 35 weeks of pregnancy and fetal fibronectin is detected, the mother is considered to be at a higher risk for preterm labor.
Negative Results on the Fetal Fibronectin Test
One of the most exciting things about this test is that if the mother’s results for fFN are negative, she has a less than 1% chance of going into preterm labor within the next 14 days. If a mother continues to have symptoms of preterm labor, the test can be repeated as often as once every two weeks.
Care Providers Base Care Plan on fFN Test Results
The fFN test is known to be so conclusive that a study in the UK (Bolt, 2009) showed that 89% of test results resulted in a change in the care plan for the mother. Both mothers who had preterm labor symptoms and those who did not participated in the study. (Symptoms of preterm labor can include cramping or contractions, abdominal pain and vaginal discharge.)
According to the study, if a mother received a negative test result on the fFN and she had been limiting her activity or even placed on bed rest due to possible symptoms, the care provider was more likely to alter her care plan to include normal activity based on the negative test result.
Looking Ahead to Prevention of Preterm Labor
The fFN has a clear benefit in the identification of mothers at risk for preterm labor. Yet much work still needs to be done in the prevention of prematurity. Studies show that treatments such as bed rest and tocolytics (muscle relaxants) are not effective in preventing preterm labor and both can have serious complications of their own. In fact, the Cochrane review board now recommends that care providers do not routinely advise bed rest for expectant mothers because of the increased health care costs and potential effects of bed rest on the mother and her family.
If you are experiencing symptoms of preterm labor, be sure to ask your medical care provider about the fFN test so that you can have as much information as possible about your risks for preterm labor and whether or not treatment is needed.
