Document Detail


Cervicovaginal fetal fibronectin for the prediction of spontaneous preterm birth in multiple pregnancies: a systematic review and meta-analysis.
MedLine Citation:
PMID:  21067303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the accuracy of cervicovaginal fetal fibronectin in predicting preterm birth in women with multiple pregnancies.
METHODS: Systematic review and meta-analysis of predictive test accuracy. Cohort or cross-sectional studies were identified through searches in databases, reference lists, proceedings, and reviews. Study selection, quality assessment, and data extraction were performed. We constructed summary receiver operating characteristic curves and calculated pooled sensitivities and specificities using a bivariate, random-effects meta-regression model. We also calculated summary likelihood ratios and post-test probabilities of preterm birth.
RESULTS: Fifteen studies (11 in asymptomatic women and 4 in women with symptoms of preterm labor) involving 1221 women with multiple pregnancies were included. Among asymptomatic women with multiple or twin pregnancies, the pooled sensitivities, specificities, and positive and negative likelihood ratios for predicting preterm birth before 32, 34, and 37 weeks' gestation ranged from 33% to 45%, 80% to 94%, 2.0 to 5.5, and 0.68 to 0.76, respectively. Among women with twin pregnancies and threatened preterm labor, the test was most accurate in predicting spontaneous preterm birth within 7 days of testing (pooled sensitivity, specificity, and positive and negative likelihood ratios of 85%, 78%, 3.9, and 0.20, respectively).
CONCLUSIONS: Cervicovaginal fetal fibronectin provides moderate to minimal prediction of preterm birth in women with multiple pregnancies. The test is most accurate in predicting spontaneous preterm birth within 7 days of testing in women with twin pregnancies and threatened preterm labor.
Authors:
Agustín Conde-Agudelo; Roberto Romero
Related Documents :
8908623 - Serial intravaginal prostaglandin e2 gel cervical ripening in preterm pregnancies.
6113493 - Should coitus late in pregnancy be discouraged?
2712123 - Late maternal age and postdate pregnancy.
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, N.I.H., Intramural; Review    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2011-02-17     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1365-76     Citation Subset:  IM    
Affiliation:
Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cervix Uteri / chemistry*
Cohort Studies
Cross-Sectional Studies
Female
Fibronectins / analysis*,  secretion
Gestational Age
Humans
Obstetric Labor, Premature / metabolism
Pregnancy
Pregnancy, Multiple*
Premature Birth / diagnosis*
Sensitivity and Specificity
Twins
Vagina / chemistry*
Grant Support
ID/Acronym/Agency:
ZIA HD002400-18/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/FFN protein, human; 0/Fibronectins
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Ionising radiation and genetic risks. XVI. A genome-based framework for risk estimation in the light...
Next Document:  Comparison of obstetrical risk in adolescent primiparas at tertiary referral centres in Tanzania and...