This Test Could Help Moms At Risk For Preterm Labor & It's An Important Step In Standardizing Prenatal Health Care
Preterm birth rates continue to rise across the United States, which is certainly a scary prospect for any expectant parent. But with the help of technology and scientific developments, a certain test could help people at risk for preterm labor.
A test like this is certainly beneficial as the preterm birth rate in the United States rose to 9.93 percent in 2017 — a .13 percent uptick from the 2016 statistic, according to the March of Dimes. The numbers are concerning, especially when you consider babies born prematurely have "higher rates of death and disability," according to the Centers for Disease Control and Prevention. And in the long-term, according to Mayo Clinic, children could experience complications such as "cerebral palsy, behavioral and psychological problems, and chronic health issues."
There are many reasons for why a parent might go into preterm labor. Kim Kardashian, for example, delivered her oldest daughter, North West, early because she had preeclampsia, a condition that causes high blood pressure. Other common causes of preterm labor include, according to the Mayo Clinic, "smoking while pregnant, diabetes, and certain infections."
Although there are many known risk factors for preterm birth, there aren't enough tools out there that can accurately assess if someone will go into labor early.
Predicting with high confidence whether someone will go into preterm labor can save lives, as well as money and time. That's where the fetal fibronectin (fFN) test comes in, a diagnostic tool used by premiere institutions like the Mayo Clinic and Brigham and Women’s Hospital.
So, what exactly is the fFN test? The test's website states:
An fFN test is a safe, simple and non-invasive test that measures whether fetal fibronectin is leaking from your uterus. Fetal fibronectin is a "glue-like" protein your body produces to help hold your baby in place. A positive test result could indicate that your body is preparing to give birth. A negative test result can give you reassurance that your chances are less than 1% of giving birth in the next 2 weeks.
A fFN test is especially helpful for someone who might be exhibiting preterm labor symptoms. Without the test, a person might be stuck at home or in a hospital worrying about all of the what ifs, a scenario the fFN test could potentially help avoid. About 99.2 percent of "women with symptoms of preterm birth who have a negative fetal fibronectin test result will not deliver their baby within the next 14 days," fFN's website states. Translation: the fFN test is very accurate.
If the fFN test comes back positive, your doctor will develop the best plan for your situation. Dr. Michael Ruma, MD, MPH, FACOG, a maternal-fetal medicine specialist from the Perinatal Associates of New Mexico, explained to Romper in an email that "the steps a doctor would take depends on each woman’s situation."
"For example, fFN testing may be completed when patients present to the hospital with uterine contractions," he continued. "Instead of simply checking the cervix with a digital examination, fFN testing can be completed along with other diagnostic modalities in order to enhance the prediction of an imminent preterm birth."
Ruma went on to explain that "fFN testing can help healthcare providers recognize when medical interventions." He added that such "interventions" should happen "while the baby is still in utero" because they "can dramatically reduce the premature baby’s risk of respiratory distress syndrome, intubation and cerebral palsy."
What's more, the tool is FDA-approved and non-invasive.
Of course, there are instances when a false positive might occur, or it's possible for a patient to receive a false negative. No test is perfect, and there are a lot of factors as to why an fFN result might be inaccurate.
"It would be amazing if all tests were perfect, but all tests in medicine have both false positive and negative results," Dr. Ruma tells Romper about the test's accuracy, adding:
... despite the potential for a false positive, [fFN] remains one of the most powerful tools to rule out preterm birth for women with symptoms of preterm labor.
Dr. Ruma — who describes himself as a "clinician who sees patients with symptoms of preterm labor regularly" — says that "one of the most interesting and useful functions about the fFN test is its high negative predictive ability." He explained:
A negative fFN test result indicates there is less than a 1 percent chance of the patient giving birth in the next 14 days, giving both the patient and her physician the confidence that discharge is appropriate. As noted in numerous studies, approximately 80 percent of women will test negative for fFN, preventing unnecessary maternal admissions, medications and costs and improve the outcomes for both mom and baby.
As to why standardizing the fFN test is important, Dr. Ruma tells Romper, "Although preterm labor symptoms are one of, if not the most likely reason a pregnant woman may be evaluated in the hospital, no standardized approach for assessing preterm labor in the United States exists." He added:
Numerous studies have shown that implementing a standardized triage protocol that includes fFN testing is a necessary and simple way for healthcare providers to rule out preterm labor, but also improve both maternal and fetal outcomes and reduce healthcare costs.
Ultimately, Dr. Ruma hopes to raise awareness among patients and health care providers "that we need to do a better job addressing the evaluation of preterm labor for pregnant women and their unborn child."
What's crucial to keep in mind here is that more needs to be done to standardize health care procedures for at-risk pregnant people. The fFN test is just one example of what can be achieved.
This first-time mom wants to have a home birth, but is she ready? Watch how a doula supports a military mom who's determined to have a home birth in Episode One of Romper's Doula Diaries, Season Two, below. Visit Bustle Digital Group's YouTube page for the next three episodes, launching Mondays in December.