title: Risk scoring systems for predicting preterm birth with the aim of reducing associated adverse outcomes.
abstract: BACKGROUND
  Identification of pregnancies that are higher risk than average is important to allow the possibility of interventions aimed at preventing adverse outcomes like preterm birth. Many scoring systems designed to classify the risk of a number of poor pregnancy outcomes (e.g. perinatal mortality, low birthweight, and preterm birth) have been developed, but they have usually been introduced without evaluation of their utility and validity.
  
  
  OBJECTIVE
  To determine whether the use of a risk-screening tool designed to predict preterm birth (in combination with appropriate consequent interventions) reduces the incidence of preterm birth and very preterm birth, and associated adverse outcomes.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2010), CENTRAL (The Cochrane Library 2010, Issue 4), MEDLINE (1966 to 17 December 2010), EMBASE (1974 to 17 December 2010), and CINAHL (1982 to 17 December 2010).
  
  
  METHODS
  All randomised or quasi-randomised (including cluster-randomised) or controlled clinical trials that compared the incidence of preterm birth between groups that used a risk scoring instrument to predict preterm birth with those who used an alternative instrument, or no instrument; or that compared the use of the same instrument at different gestations. The reports may have been published in peer reviewed or non-peer reviewed publications, or not published, and written in any language.
  
  
  METHODS
  All review authors planned to independently assess for inclusion all the potential studies we identified as a result of the search strategy. However, we identified no eligible studies.
  
  
  RESULTS
  Extensive searching revealed no trials of the use of risk scoring systems to prevent preterm birth.
  
  
  CONCLUSIONS
  The role of risk scoring systems in the prevention of preterm birth is unknown.There is a need for prospective studies that evaluate the use of a risk-screening tool designed to predict preterm birth (in combination with appropriate consequent interventions) to prevent preterm birth, including qualitative and/or quantitative evaluation of their impact on women's well-being. If these prove promising, they should be followed by an adequately powered, well-designed randomised controlled trial.
authors.affiliation: 1Mother and Child Health Research, La Trobe University, Melbourne, Australia. m.davey@latrobe.edu.au
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Davey
authors.forename: Lyndsey
authors.initials: L
authors.lastname: Watson
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Rayner
authors.forename: Shelley
authors.initials: S
authors.lastname: Rowlands
mesh_terms: D005260:Female; D006801:Humans; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000175:diagnosis* / Q000517:prevention & control; D018570:Risk Assessment / Q000379:methods