ObjectiveTo determine the risk of recurrent spontaneous preterm birth (sPTB) following sPTB in singleton pregnancies.DesignSystematic review and meta-analysis using random effects models.Data sourcesAn electronic literature search was conducted in OVID Medline (1948–2017), Embase (1980–2017) and ClinicalTrials.gov (completed studies effective 2017), supplemented by hand-searching bibliographies of included studies, to find all studies with original data concerning recurrent sPTB.Study eligibility criteriaStudies had to include women with at least one spontaneous preterm singleton live birth (<37 weeks) and at least one subsequent pregnancy resulting in a singleton live birth. The Newcastle-Ottawa Scale was used to assess study quality.ResultsOverall, 32 articles involving 55 197 women, met all inclusion criteria. Generally studies were well conducted and had a low risk of bias. The absolute risk of recurrent sPTB at <37 weeks’ gestation was 30% (95% CI 27% to 34%). The risk of recurrence due to preterm premature rupture of membranes (PPROM) at <37 weeks gestation was 7% (95% CI 6% to 9%), while the risk of recurrence due to preterm labour (PTL) at <37 weeks gestation was 23% (95% CI 13% to 33%).ConclusionsThe risk of recurrent sPTB is high and is influenced by the underlying clinical pathway leading to the birth. This information is important for clinicians when discussing the recurrence risk of sPTB with their patients.

SYNOPSISThe aims of this study were, first, to estimate the prevalence of depressive disorders in Australian nursing home residents using international diagnostic criteria, and second, to explore environmental determinants of such disorders. Residents of 24 nursing homes were surveyed using the Canberra Interview for the Elderly (CIE) and a range of environmental measures was also taken. Of 323 residents who were screened for cognitive impairment, 165 (51%) scored 18 or above on the Mini-Mental State Examination (Folstein et al. 1975), and were interviewed with the CIE. According to DSM-III-R criteria and the CIE, the prevalence of major depressive episode was 9·7%. Using ICD-10 criteria, 6·1% of residents suffered from a severe depressive episode, 6·7% from a moderate depressive episode and 6·7% from a mild depressive episode. Some measures of the social environment were significantly related to depressive symptoms.

At a cut-off of > or = 4 the 15-item GDS can be recommended as a case detector for significant forms of depression in older African-Caribbean people living in south London.

Previous research and our own observations suggested that older Caribbean people might use terms for emotional distress that differed from those found in standard screening instruments. Using a combination of qualitative approaches derived from the ‘new cross‐cultural psychiatry’, we have developed a new 13‐item culture‐specific screen containing items which both overlap and differ from those found in, for example, the Geriatric Depression Scale. Further research is in progress to test the validity of this screen in a large community sample.