Cervicovaginal fetal fibronectin as a marker for preterm delivery: A meta-analysis

OBJECTIVE: We performed a meta-analysis to determine the value of cervicova ginal fetal fibronectin as a marker for preterm delivery. STUDY DESIGN: Selection criteria confined the analysis to original, English -language reports of prospective studies including women at <37 weeks' gest ation with intact amniotic membranes. For the outcomes of delivery at <37 o r <34 weeks' gestation or delivery within 7, 14, 21, or 28 days after fibro nectin sampling, we calculated sensitivity and specificity rates for each s tudy, for subgroups of studies, and for all studies combined. RESULTS: A total of 27 studies met our inclusion criteria. For the outcomes of delivery at <37 and <34 weeks' gestation, overall sensitivity rates wer e 56% and 61% and overall specificity rates were 84% and 83%, respectively. For the outcomes of delivery within 7, 14, 21, and 28 days, we calculated sensitivity rates of 76%, 68%, 61%, and 43% and specificity rates of 88%, 8 9%, 91%, and 93%, respectively. For the subgroup of patients with symptoms of preterm labor, sensitivity rates for delivery within 7, 14, 21, and 28 d ays of 89%, 78%, 76%, and 71% and specificity rates of 86%, 86%, 88%, and 8 3%, respectively, were calculated. CONCLUSION: Among patients with symptoms of preterm labor, cervicovaginal f etal fibronectin appears to be among the most effective predictors of prete rm delivery.