Fetal Fibronectin Testing for Pre-Term Labour: Put to the Test in Canada’s Arctic

In remote northern and Arctic communities of Canada, the birth of premature infants can be associated with considerable health problems.

Testing for fetal fibronectin (fFN) can be used to predict the onset of pre-term birth in women with symptoms of pre-term labour. The presence of fFN, a protein found in cervical secretions, is associated with pre-term labour. A negative result can avoid the unnecessary transfer of women not yet confirmed to have imminent delivery to hospitals in larger centres. This information provides additional value in rural and remote communities.

The use of fFN testing is associated with a reduction in negative health outcomes, hospital admissions, length of hospital stay, and hospital costs in the management of suspected pre-term labour.¹ In addition, significant social stresses for rural women and their families may also be avoided.

CADTH’s Health Technology Inquiry Service (HTIS) has produced three assessments of the clinical-effectiveness of fFN testing to predict pre-term labour and reduce non-essential transport or hospital length of stay. These assessments have been produced in response to inquiries from the territory of Nunavut, which has since distributed the fFN test to all of its health care centers and hospitals. In addition to CADTH’s HTIS assessments, Nunavut has also conducted a pilot study in 2004 involving 33 patients in the region.

For Canada’s northern communities, the impact on health care costs is noteworthy. The reduction of medical travel costs to transport patients from their home communities to the capital city of Iqaluit or to a southern centre such as Winnipeg or Ottawa is a significant consideration when deciding to provide health services based on the use of this technology. By preventing unnecessary medical evacuations, the stress on pregnant women and their families is greatly reduced as a result. The fFN test is intended to be a useful tool in assisting health care providers with rapid clinical assessment of pre-term labour and related care.  

References

1. Macdonald W. Alaska Med Supp 2007.