Melchor JC, et al. - Researchers conducted a systematic review and meta-analysis of the literature in order to determine the accuracy of placental alpha microglobulin-1 (PAMG-1), fetal fibronectin (fFN) and phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) tests in predicting spontaneous preterm birth (sPTB) within 7 days of testing in women with symptoms of preterm labor. In addition, they investigated the test performance of each biomarker according to pretest probability of sPTB ≤ 7 days. Outcomes revealed significantly higher positive predictive value (PPV) of PAMG-1 than that of phIGFBP-1 or fFN in predicting sPTB within 7 days of testing in women with signs and symptoms of PTL. The three biomarker tests did not differ regarding the other diagnostic accuracy measures. Optimal Management could be achieved via using a highly specific assay for a lower-prevalence syndrome, such as sPTB, as prevalence affects the predictive performance of a diagnostic test.