title: The short-term prediction of preterm birth: a systematic review and diagnostic metaanalysis.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of fetal fibronectin (fFN), fetal breathing movements (FBM), and cervical length (CL) for the short-term prediction of preterm birth in symptomatic patients.
  
  
  METHODS
  Diagnostic metaanalysis using bivariate methods.
  
  
  RESULTS
  Pooled sensitivities for fFN, FBM, and CL for delivery within 48 hours of testing were 0.62 (95% confidence interval [CI], 0.43-0.78), 0.75 (95% CI, 0.57-0.87) and 0.77 (95% CI, 0.54-0.90), respectively. Pooled specificities for fFN, FBM, and CL for delivery within 48 hours were 0.81 (95% CI, 0.74-0.86), 0.93 (95% CI, 0.75-0.98) and 0.88 (95% CI, 0.84-0.91). Pooled sensitivities for fFN, FBM, and CL for delivery within 7 days were 0.75 (95% CI, 0.69-0.80), 0.67 (95% CI, 0.43-0.84), and 0.74 (95% CI, 0.58-0.85). Pooled specificities for fFN, FBM, and CL for delivery within 7 days were 0.79 (95% CI, 0.76-0.83), 0.98 (95% CI, 0.83-1.00) and 0.89 (95% CI, 0.85-0.92). Based on a pretest probability of 10% for delivery within 48 hours, posttest probabilities (positive and negative) were 27% and 5% for fFN, 54% and 3% for fFN, and 42% and 3% for CL. For a pretest probability of 20% for delivery within 7 days, posttest probabilities (positive and negative) were 48% and 7% for fFN, 89% and 8% for FBM, and 63% and 7% for CL.
  
  
  CONCLUSIONS
  In symptomatic patients, for fFN, absence of FBM, and CL have diagnostic use as predictors of delivery within 48 hours and within 7 days of testing. Absence of FBM appears to be the best test for predicting preterm birth.
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL. Electronic address: amy.boots@jax.ufl.edu.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Boots
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL.
authors.forename: Luis
authors.initials: L
authors.lastname: Sanchez-Ramos
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Bowers
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, FL.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Kaunitz
authors.affiliation: Clinical Biostatistics Unit, Ramon y Cajal Hospital, Madrid, and CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Zamora
authors.affiliation: Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Schlattmann
mesh_terms: D002584:Cervix Uteri; D005260:Female; D005333:Fetus; D005353:Fibronectins / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis*; D012143:Respiratory Physiological Phenomena; D012680:Sensitivity and Specificity
chemical_list: D005353:Fibronectins
keywords: cervical length; fetal breathing movements; fetal fibronectin; preterm birth