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

Abstract

Objective: We performed a meta-analysis to determine the value of cervicovaginal 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’ gestation with intact amniotic membranes. For the outcomes of delivery at <37 or <34 weeks’ gestation or delivery within 7, 14, 21, or 28 days after fibronectin sampling, we calculated sensitivity and specificity rates for each study, 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 were 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%, 89%, 91%, and 93%, respectively. For the subgroup of patients with symptoms of preterm labor, sensitivity rates for delivery within 7, 14, 21, and 28 days of 89%, 78%, 76%, and 71% and specificity rates of 86%, 86%, 88%, and 83%, respectively, were calculated. Conclusion: Among patients with symptoms of preterm labor, cervicovaginal fetal fibronectin appears to be among the most effective predictors of preterm delivery. (Am J Obstet Gynecol 1999;180:1169-76.)