Association between cervical length and gestational age at birth in singleton pregnancies: a multicentric prospective cohort study in the brazilian population

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dc.creatorThais Valéria Silva
dc.creatorRodolfo Carvalho Pacagnella
dc.creatorAllan R. Hatanaka
dc.creatorAmanda Dantas
dc.creatorAntonio Fernandes Moron
dc.creatorCarlos Augusto Santos Menezes
dc.creatorCláudio Sérgio Medeiros Paiva
dc.creatorCristhiane B. Marques
dc.creatorCynara Maria Pereira
dc.creatorDaniela Dos Santos Lopes Homenko
dc.creatorDjacyr Magna Cabral Paiva
dc.creatorAnderson Borovac-Pinheiro
dc.creatorJosé Guilherme Cecatti
dc.creatorBen Willem Mol
dc.creatorMário Dias Corrêa Júnior
dc.creatorFabricio Silva Costa
dc.creatorMarcelo Santucci França
dc.creatorRenato Teixeira Souza
dc.creatorRoland Devlieger
dc.creatorRenato Passini
dc.date.accessioned2024-10-11T21:38:40Z
dc.date.accessioned2025-09-08T23:54:38Z
dc.date.available2024-10-11T21:38:40Z
dc.date.issued2023
dc.description.sponsorshipCNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.format.mimetypepdf
dc.identifier.doi10.1186/s12978-022-01557-w
dc.identifier.issn1742-4755
dc.identifier.urihttps://hdl.handle.net/1843/77401
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofReproductive Health
dc.rightsAcesso Aberto
dc.subjectMedida do Comprimento Cervical
dc.subjectNascimento Prematuro
dc.subjectGravidez
dc.titleAssociation between cervical length and gestational age at birth in singleton pregnancies: a multicentric prospective cohort study in the brazilian population
dc.typeArtigo de periódico
local.citation.epage10
local.citation.issue1
local.citation.spage1
local.citation.volume20
local.description.resumoBackground: Short cervical length measured during the second trimester of pregnancy is an important risk factor for spontaneous preterm birth (sPTB). The aim of this study is to identify the association between mid-pregnancy cervical length (CL) and gestational age at birth in asymptomatic singleton pregnant women. Methods: This is a prospective cohort study involving singleton pregnant women who participated in the screening phase of a Brazilian multicenter randomized controlled trial (P5 trial) between July 2015 and March 2019. Transvaginal ultrasound to measure CL was performed from 18 to 22 + 6 weeks. Women with CL ≤ 30 mm received vaginal progesterone (200 mg/day) until 36 weeks’ gestation. For this analysis we considered all women with CL ≤ 30 mm receiving progesterone and a random selection of women with CL > 30 mm, keeping the populational distribution of CL. We obtained prognostic effectiveness data (area under receive operating characteristic curve (AUC), sensitivity and specificity and estimated Kaplan–Meier curves for preterm birth using different CL cutoff points. Results: We report on 3139 women and identified a negative association between cervical length and sPTB. CL ≤ 25 mm was associated with sPTB < 28, sPTB < 34 and sPTB < 37 weeks, whereas a CL 25–30 mm was directly associated with late sPTB. CL by transvaginal ultrasound presented an AUC of 0.82 to predict sPTB < 28 weeks and 0.67 for sPTB < 34 weeks. Almost half of the sPTB occurred in nulliparous women and CL ≤ 30 mm was associated with sPTB at < 37 weeks (OR = 7.84; 95%CI = 5.5–11.1). The number needed to screen to detect one sPTB < 34 weeks in women with CL ≤ 25 mm is 121 and we estimated that 248 screening tests are necessary to prevent one sPTB < 34 weeks using progesterone prophylaxis. Conclusions: CL measured by transvaginal ultrasound should be used to predict sPTB < 34 weeks. Women with CL ≤ 30 mm are at increased risk for late sPTB.
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE GINECOLOGIA OBSTETRÍCIA
local.publisher.initialsUFMG
local.url.externahttps://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-022-01557-w

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