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Prediction of spontaneous preterm birth: no good test for predicting a spontaneous preterm birth

Honest Honest1, Chris J Hyde, Khalid S Khan

  • 1Department of Obstetrics and Gynaecology, Good Hope Hospital, Heart of England NHS Trust, Birmingham, UK. honest.honest@heartofengland.nhs.uk

Current Opinion in Obstetrics & Gynecology
|October 27, 2012
PubMed

Insights

Predicting spontaneous preterm birth is crucial for neonatal health. While many tests exist, none offer exceptional accuracy, and study quality is often poor, hindering effective screening strategies.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Reproductive Health

Background:

  • Spontaneous preterm birth (SPB) affects 3-11% of pregnancies globally.
  • SPB is a leading cause of neonatal mortality and morbidity.
  • Accurate prediction could enable timely interventions to reduce complications.

Purpose of the Study:

  • To systematically review and evaluate candidate tests for predicting SPB.
  • To collate information on multiple predictive tests simultaneously.
  • To inform the development of screening strategies and decision-making frameworks.

Main Methods:

  • Systematic review of 319 studies.
  • Evaluation of 22 different tests for SPB prediction.
  • Analysis of test accuracy metrics, including likelihood ratios (LR+ and LR-).

Main Results:

  • Numerous promising tests were identified, including previous SPB history, cervicovaginal markers (fibronectin, HCG), cervical ultrasound, serum CRP, and amniotic fluid interleukins.
  • No single test demonstrated exceptional accuracy for predicting SPB.
  • Study quality was generally poor, impacting the reliability of findings.
  • Some tests showed high positive likelihood ratios (LR+) but low negative likelihood ratios (LR-), and vice versa.

Conclusions:

  • Current tests for predicting SPB lack sufficient accuracy for widespread clinical use.
  • The poor quality of existing studies limits the ability to establish reliable screening protocols.
  • Further high-quality research is needed to develop accurate and effective SPB prediction methods.
Abstract

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