| Cervicovaginal fetal fibronectin for the prediction of spontaneous preterm birth in multiple pregnancies: a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 21067303 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Agustín Conde-Agudelo; Roberto Romero |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, N.I.H., Intramural; Review |
Journal Detail:
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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:
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Created Date: 2010-11-11 Completed Date: 2011-02-17 Revised Date: 2013-03-28 |
Medline Journal Info:
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Nlm Unique ID: 101136916 Medline TA: J Matern Fetal Neonatal Med Country: England |
Other Details:
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Languages: eng Pagination: 1365-76 Citation Subset: IM |
Affiliation:
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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:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cervix Uteri
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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:
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ZIA HD002400-18/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/FFN protein, human; 0/Fibronectins |
| Comments/Corrections | |
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