Fetal adrenal gland measurements as predictors of spontaneous preterm birth: a systematic review and meta-analysis
Year: 2026
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: Purpose To evaluate the diagnostic performance of fetal adrenal gland biometry, specifically corrected adrenal gland volume (cAGV) and fetal zone (FZ), for predicting spontaneous preterm birth (PTB) and delivery within 7 days after ultrasound assessment primarily in symptomatic pregnancies. Methods A Systematic review and meta-analysis (SRMA) was conducted in accordance with the PRISMA-DTA statement. MEDLINE, Embase, and Scopus were searched through August 31, 2025. Diagnostic accuracy was pooled using a bivariate random-effects model when feasible; AUC and I 2 were obtained using complementary random-effects split component synthesis. Results Thirteen studies (1,620 singleton pregnancies) were included. For cAGV predicting PTB < 37 weeks (5 studies; n = 677), pooled sensitivity and specificity were 91% (95% CI 82–95%) and 88% (95% CI 77–94%), with area under the curve (AUC) of 0.95 (95% CI 0.86–0.98) and I 2 = 0%. For delivery within 7 days (4 studies; n = 495), pooled sensitivity and specificity were 82% (95% CI 67–91%) and 87% (95% CI 64–96%), with an AUC of 0.84 (95% CI 0.59–0.95) and I 2 = 93.8%. For the FZ depth-to-total gland depth ratio (d/D), accuracy was lower (AUC 0.81 for PTB and 0.70 for delivery within 7 days), with heterogeneity I 2 = 0% for PTB and 87.2% for delivery within 7 days. Conclusion Fetal adrenal gland biometry, particularly cAGV, shows promising diagnostic performance for predicting spontaneous PTB and delivery within 7 days. FZ d/D demonstrates lower diagnostic accuracy, while substantial heterogeneity in short-term delivery analyses warrants cautious interpretation.
Institution: Srinakharinwirot University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,590
OpenAlex ID: W7225413741