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Correlation and predictive analyses were performed by Spearman\u2019s correlation, and binary logistic regression and area under receiver operating characteristic curve (AUC), respectively. Of the 168 women enrolled, only CVF samples from 135 (80.4%) women were analysed. There were 6\/135 (4.4%) spontaneous PTB (sPTBs), with two of these pregnancies ending\u2009\u2264\u200928\u00a0weeks\u2019 gestation. Individually (AUC, 95% CI), only glutamate (0.72, 0.64\u20130.80) and CL (0.69, 0.60\u20130.77) were predictive of PTB. However, five multivariable models that more accurately predicted sPTB were also identified, i.e. a combination of: glutamate, acetate and D-lactate (GAD, 0.82, 0.74\u20130.89); CL and qfFN only (0.78, 0.70\u20130.85); CL, qfFN, glutamate and acetate (0.88, 0.81\u20130.93); CL, qfFN and GAD (0.94, 0.88\u20130.98); and GAD and pH (0.86, 0.79\u20130.92). Correlations between CL, pH and qfFN and metabolites were also observed. In this cohort, a midtrimester combination of CVF glutamate, acetate and D-lactate predicted preterm birth more accurately than individual metabolites, cervical length and fetal fibronectin with a very low false-positive rate and high positive predictive value. Further testing in populations with higher preterm birth rates is required.<\/jats:p>","DOI":"10.1007\/s43032-021-00711-2","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T14:02:39Z","timestamp":1628604159000},"page":"915-922","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Combination of Cervicovaginal Fluid Glutamate, Acetate and D-Lactate Identified Asymptomatic Low-Risk Women Destined to Deliver Preterm: a Prospective Cohort Study"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3924-5270","authenticated-orcid":false,"given":"Emmanuel","family":"Amabebe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2502-3033","authenticated-orcid":false,"given":"Dilly O. 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