We characterized the metabolite profile of cervicovaginal fluid (CVF) of a cohort of pregnant women presenting with symptoms of preterm labor by both 1H Magnetic Resonance spectroscopy and spectrophotometric acetate enzyme assay. Acetate normalized integral (P=0.002) and spectrophotometry (P=0.006) were significantly higher in the women who delivered preterm compared to their term counterparts. Both methods were predictive of PTB <37 weeks (acetate integral: AUC=0.75, spectrophotometry: AUC=0.74). Elevated CVF acetate in women with symptoms of preterm labor appears predictive of preterm delivery. In these women, a clinical assay of acetate in CVF may prove of clinical utility for predicting PTB.