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Summary statistics were independently extracted by two reviewers, tabulated and analysed descriptively. The ROBIS tool was used to evaluate risk of bias of included systematic reviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Twelve reviews performed meta\u2010analyses: two were reported as systematic reviews of prognostic factor studies, ten used diagnostic test accuracy methodology. Ten systematic reviews were at high or unclear risk of bias. Meta\u2010analyses reported up to 80 combinations of cervical length, gestational age at measurement and definition of preterm birth. Cervical length was consistently associated with SPTB, with a likelihood ratio for a positive test of 1.70\u2013142.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ability of cervical length to predict SPTB is a prognostic research question; systematic reviews typically analysed diagnostic test accuracy. Individual participant data meta\u2010analysis using prognostic factor research methods is recommended to better quantify how well transvaginal ultrasonographic cervical length can predict SPTB.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17443","type":"journal-article","created":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T23:24:20Z","timestamp":1678058660000},"page":"866-879","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnosis or prognosis? An umbrella review of mid\u2010trimester cervical length and spontaneous preterm birth"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3790-7741","authenticated-orcid":false,"given":"Kelly","family":"Hughes","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4254-460X","authenticated-orcid":false,"given":"Shakila","family":"Thangaratinam","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Women's Health, Institute of Translational Medicine University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-6971","authenticated-orcid":false,"given":"Shaun","family":"Brennecke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Maternal\u2010Fetal Medicine &amp; Pregnancy Research Centre Royal Women's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"},{"name":"Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and Nutrition University of Aberdeen  Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6622-8134","authenticated-orcid":false,"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"UN Inter\u2010agency Group for Child Mortality Estimation UNICEF WHO The World Bank United Nations DoEaSA Population Division Division UNECfLAatCP.Levels & trends in child mortality: report 2012: IGME.2012. 32 p."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1571150"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.127"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-10-S1-S1"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90598-3"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/8756479303019003004"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1373"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.09.004"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.106851"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.027"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2018.09.019"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.11.016"},{"key":"e_1_2_12_15_1","unstructured":"Committee RWsH.NICE Guideline: Antenatal Care. 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