QUIDS - using fibronectin to find out which women with symptoms of preterm labour are at risk

Sarah Stock, Jane Norman, Andrew Shennan, John Norrie Kathleen Boyd, Ben Mol Susan Harper-Clarke, Irene Brady, Tina Lavender, Khalid Khan, Rachel Morris, Manju Chandiramani, Asma Khalil, Lesley Jackson, Jon Dorling, Richard Riley

Researchers in our Edinburgh centre are working on a new, more accurate test for predicting premature birth.

Up to 80% of women who have signs of premature labour – like contractions or stomach pain – are still pregnant after 7 days. However, it is very difficult to tell which of these women are actually at risk of premature birth. A lot of women are treated ‘just in case,’ as doing nothing could have devastating consequences.

A test called quantitative fetal fibronectin (fFN) could help change this.

Fetal fibronectin is a special protein made by babies’ cells in the womb, and acts as a 'glue' that keeps the amniotic sac attached to the lining of the womb.

The protein can be tested by taking a swab, which is analyzed to give results in less than ten minutes. The lower the concentration of fFN, the less likely a woman is to give birth early.

A test that simply gives a positive or negative result has been available for a while. However, this new test could rule out preterm labour more accurately than ever. In work funded by the National Institute for Health Research, Tommy’s researchers have looked at earlier studies to find out if a more accurate fetal fibronectic test is likely to be useful. They have also looked at which other clinical factors could be used together with the test to best diagnose premature labour.

We are now trialling the test to predict if a woman will deliver within seven days at 26 maternity units in the UK. So far, we have recruited 1500 women with symptoms of preterm labour. Using our results, we’ll develop a support tool to help women and clinicians decide how likely premature birth is, and whether a woman should start treatment.

If it works, this tool could help stop women who aren’t at risk being unnecessarily admitted to hospital. This means we can focus care on those women who need it most, and avoid stress, worry, and treatment for those who don’t.

Read more about our work on using fetal fibronectin to find women at risk of preterm birth
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This study takes place in a Tommy's centre and is funded by the National Institute for Health Research's Health Technology Assessment programme

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