Smith Valerie, Devane Declan, Begley Cecily M, Clarke Mike, Higgins Shane
School of Nursing and Midwifery, The University of Dublin, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
Eur J Obstet Gynecol Reprod Biol. 2007 Aug;133(2):134-42. doi: 10.1016/j.ejogrb.2007.03.005. Epub 2007 Apr 23.
This systematic review aims to identify reviews of fetal fibronectin and transvaginal cervical length for predicting preterm birth, so that these could be appraised and the findings from good quality reviews highlighted. Reviews, rather than individual studies, are the basis for this systematic review because of the proliferation of reviews and the benefits of a single, consistent appraisal and assessment of evidence from these reviews, rather than further attempts to find and appraise the many individual studies in the literature. Potentially eligible reviews were sought primarily through searches of the electronic databases MEDLINE (1966-2005), EMBASE (1980-2005), CINHAL (1982-2005), Science Citation Index (1970-2005) and The Cochrane Library (Issue 3, 2005). Our systematic review consists of a description of the two factors that might be predictive of preterm birth and for which at least one relevant review was found. The scope and quality of the identified review(s) are described, and their conclusions and the strength of these conclusions discussed. Ten reviews were identified, of which seven were included in this systematic review of reviews. The quality of each review is assessed within the following domains; the extent of searching undertaken, description of study selection and inclusion criteria, comparability of included studies, assessment of publication bias, assessment of heterogeneity and conduct of sensitivity analyses. The reviews we identified show that cervicovaginal fetal fibronectin and transvaginal sonographic cervical length measurements are clinically useful factors in predicting preterm birth. Consideration might be given to the use of both the measurement of cervicovaginal fetal fibronectin and transvaginal sonographic assessment of cervical length to identify women at increased risk of preterm birth and, potentially, to improve the outcome for these women and their babies.
本系统评价旨在识别关于胎儿纤连蛋白和经阴道测量宫颈长度以预测早产的综述，以便对这些综述进行评估，并突出高质量综述的研究结果。由于综述数量众多，且对这些综述的证据进行单一、一致的评估有诸多益处，而非进一步尝试查找和评估文献中的众多个体研究，因此综述而非个体研究是本系统评价的基础。主要通过检索电子数据库MEDLINE（1966 - 2005年）、EMBASE（1980 - 2005年）、CINHAL（1982 - 2005年）、科学引文索引（1970 - 2005年）和考克兰图书馆（2005年第3期）来寻找可能符合条件的综述。我们的系统评价包括对两个可能预测早产且至少找到一篇相关综述的因素的描述。描述了已识别综述的范围和质量，并讨论了它们的结论以及这些结论的力度。共识别出10篇综述，其中7篇纳入了本综述的系统评价。在以下领域评估每篇综述的质量：检索范围、研究选择和纳入标准的描述、纳入研究的可比性、发表偏倚评估、异质性评估以及敏感性分析的开展情况。我们识别出的综述表明，宫颈阴道胎儿纤连蛋白和经阴道超声测量宫颈长度是预测早产的临床有用因素。可考虑同时使用宫颈阴道胎儿纤连蛋白测量和经阴道超声评估宫颈长度来识别早产风险增加的女性，并有可能改善这些女性及其婴儿的结局。
