Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor

OBJECTIVES: To identify pregnant health plan members triaged through the emergency department (ED), including labor and delivery (ELD) units, with symptoms of preterm labor (PTL), and evaluate the use of fetal fibronectin (fFN) testing; and to calculate the rate of hospitalization and timing of deli...

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Published in:	Clinicoecon Outcomes Res
Main Authors:	Blackwell, Sean C, Sullivan, Erin M, Petrilla, Allison A, Shen, Xian, Troeger, Kathleen A, Byrne, James D
Format:	Artigo
Language:	Inglês
Published:	Dove Medical Press 2017
Subjects:	Original Research
Online Access:	https://ncbi.nlm.nih.gov/pmc/articles/PMC5633307/ https://ncbi.nlm.nih.gov/pubmed/29042802 https://ncbi.nlm.nih.govhttp://dx.doi.org/10.2147/CEOR.S141061
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spelling	pubmed-56333072017-10-17 Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor Blackwell, Sean C Sullivan, Erin M Petrilla, Allison A Shen, Xian Troeger, Kathleen A Byrne, James D Clinicoecon Outcomes Res Original Research OBJECTIVES: To identify pregnant health plan members triaged through the emergency department (ED), including labor and delivery (ELD) units, with symptoms of preterm labor (PTL), and evaluate the use of fetal fibronectin (fFN) testing; and to calculate the rate of hospitalization and timing of delivery in relation to the ED visit. METHODS: Retrospective cohort study using Medical Outcomes Research for Effectiveness and Economics Registry(®), a national multipayer claims database. A cohort of pregnant women evaluated in an ELD with a diagnosis of PTL from June 2012 through November 2015 was identified. The proportion of women with PTL who received fFN testing was calculated. RESULTS: A total of 23,062 patients met the criteria for inclusion in the study. The rate of fFN testing prior to delivery was 12.0%. Of the 23,062 patients included in the analysis, 75.9% were discharged home. Of those who were discharged from the emergency room, one in five went on to deliver within 3 days and almost 96% of this group was not screened for the presence of fFN. Of the remaining 24.1% of patients admitted to the hospital, 91.3% delivered during their stay. In a sensitivity analysis, the percentage of women who delivered within 3 days of the ELD encounter was lower for women who received fFN testing only (6.6%) versus those who had a history of transvaginal ultrasound (TVUS) only (21.6%). Furthermore, the rate of delivery within 3 days was lowest among patients who had both fFN testing and TVUS (4.7%). CONCLUSION: The utilization of fFN testing is 12%. The majority of pregnant patients triaged through the ELD with symptomatic PTL do not receive an fFN test. As part of PTL evaluation, fFN testing may identify women at increased risk for preterm delivery and help determine appropriate patient management. Dove Medical Press 2017-10-03 /pmc/articles/PMC5633307/ /pubmed/29042802 http://dx.doi.org/10.2147/CEOR.S141061 Text en © 2017 Blackwell et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
institution	US NLM
collection	PubMed Central
language	Inglês
format	Artigo
topic	Original Research
spellingShingle	Original Research Blackwell, Sean C Sullivan, Erin M Petrilla, Allison A Shen, Xian Troeger, Kathleen A Byrne, James D Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
description	OBJECTIVES: To identify pregnant health plan members triaged through the emergency department (ED), including labor and delivery (ELD) units, with symptoms of preterm labor (PTL), and evaluate the use of fetal fibronectin (fFN) testing; and to calculate the rate of hospitalization and timing of delivery in relation to the ED visit. METHODS: Retrospective cohort study using Medical Outcomes Research for Effectiveness and Economics Registry(®), a national multipayer claims database. A cohort of pregnant women evaluated in an ELD with a diagnosis of PTL from June 2012 through November 2015 was identified. The proportion of women with PTL who received fFN testing was calculated. RESULTS: A total of 23,062 patients met the criteria for inclusion in the study. The rate of fFN testing prior to delivery was 12.0%. Of the 23,062 patients included in the analysis, 75.9% were discharged home. Of those who were discharged from the emergency room, one in five went on to deliver within 3 days and almost 96% of this group was not screened for the presence of fFN. Of the remaining 24.1% of patients admitted to the hospital, 91.3% delivered during their stay. In a sensitivity analysis, the percentage of women who delivered within 3 days of the ELD encounter was lower for women who received fFN testing only (6.6%) versus those who had a history of transvaginal ultrasound (TVUS) only (21.6%). Furthermore, the rate of delivery within 3 days was lowest among patients who had both fFN testing and TVUS (4.7%). CONCLUSION: The utilization of fFN testing is 12%. The majority of pregnant patients triaged through the ELD with symptomatic PTL do not receive an fFN test. As part of PTL evaluation, fFN testing may identify women at increased risk for preterm delivery and help determine appropriate patient management.
author	Blackwell, Sean C Sullivan, Erin M Petrilla, Allison A Shen, Xian Troeger, Kathleen A Byrne, James D
author_facet	Blackwell, Sean C Sullivan, Erin M Petrilla, Allison A Shen, Xian Troeger, Kathleen A Byrne, James D
author_sort	Blackwell, Sean C
title	Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
title_short	Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
title_full	Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
title_fullStr	Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
title_full_unstemmed	Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
title_sort	utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor
publisher	Dove Medical Press
container_title	Clinicoecon Outcomes Res
publishDate	2017
url	https://ncbi.nlm.nih.gov/pmc/articles/PMC5633307/ https://ncbi.nlm.nih.gov/pubmed/29042802 https://ncbi.nlm.nih.govhttp://dx.doi.org/10.2147/CEOR.S141061
_version_	1820135405840760832

Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor

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