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Maternal and obstetrical factors associated with short cervical length at midtrimester in women with no history of preterm delivery
In pregnant women evaluated at 18/0 and 23/6 weeks + days of gestation without history of preterm delivery, a 16.7% detection rate for short cervix ≤15 mm can be achieved by risk factors BMI ≥30, and at least one previous miscarriage. Nevertheless, screening for short cervix by risk factors among lo...
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| Published in: | The journal of maternal-fetal & neonatal medicine 2023-12, Vol.36 (2), p.2228448-2228448 |
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| creator | Soto-Torres, Eleazar E. Hernandez-Andrade, Edgar Huntley, Erin S. Blackwell, Sean C. |
| description | In pregnant women evaluated at 18/0 and 23/6 weeks + days of gestation without history of preterm delivery, a 16.7% detection rate for short cervix ≤15 mm can be achieved by risk factors BMI ≥30, and at least one previous miscarriage. Nevertheless, screening for short cervix by risk factors among low risk women might not be an effective alternative to universal cervical length screening.
To evaluate associations between maternal characteristics and a short cervix in patients without history of preterm delivery, and to determine if these characteristics can predict the presence of a short cervix.
This is a retrospective cohort study that included 18,592 women with singleton pregnancies without history of previous preterm deliveries who underwent universal transvaginal cervical length (TVCL) screening between 18 + 0 and 23 + 6 weeks/days of gestation. A short cervix was defined as a cervical length (CL) ≤25 mm, ≤20 mm, and ≤15 mm. Associations between maternal age, weight, height, body mass index (BMI), previous term deliveries, and history of previous miscarriages, with a short cervix were evaluated using logistic regression models.
The prevalence of a short cervix in our population was: CL ≤25 mm, 2.2% (n = 403); CL ≤20 mm, 1.2% (n = 224); and CL ≤15 mm, 0.9% (n = 161). Women with BMI >30 and/or previous abortions constituted 45.5% of the total population (8463/18,582). Significant associations with short cervix were observed for women with BMI ≥30, and for women with at least one previous abortion (p |
| doi_str_mv | 10.1080/14767058.2023.2228448 |
| format | article |
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To evaluate associations between maternal characteristics and a short cervix in patients without history of preterm delivery, and to determine if these characteristics can predict the presence of a short cervix.
This is a retrospective cohort study that included 18,592 women with singleton pregnancies without history of previous preterm deliveries who underwent universal transvaginal cervical length (TVCL) screening between 18 + 0 and 23 + 6 weeks/days of gestation. A short cervix was defined as a cervical length (CL) ≤25 mm, ≤20 mm, and ≤15 mm. Associations between maternal age, weight, height, body mass index (BMI), previous term deliveries, and history of previous miscarriages, with a short cervix were evaluated using logistic regression models.
The prevalence of a short cervix in our population was: CL ≤25 mm, 2.2% (n = 403); CL ≤20 mm, 1.2% (n = 224); and CL ≤15 mm, 0.9% (n = 161). Women with BMI >30 and/or previous abortions constituted 45.5% of the total population (8463/18,582). Significant associations with short cervix were observed for women with BMI ≥30, and for women with at least one previous abortion (p < .001). Parous women had a significantly lower association with a short cervix than nulliparous women (p < .001). Maternal age or height were not associated with a short cervix. Prediction of short cervix based on presence of any of the following: BMI ≥ 30 or previous abortions showed sensitivities of 55.8% (≤25 mm), 61.6% (≤20 mm), and 63.4% (≤15 mm) with similar specificity (50.1-54.6%) and likelihood ratio positive (1.2-1.5); and prediction based on BMI ≥ 30 and previous abortions showed sensitivities of 11.1% (≤25 mm), 14.7% (≤20 mm), and 16.7% (≤15 mm) with specificity 93%.
Among low risk women for spontaneous preterm delivery, those with a BMI ≥30 and/or previous miscarriages had a significantly increased risk for a short cervix at 18 + 0 and 23 + 6 weeks/days of gestation. Despite these significant associations, screening by maternal risk factors in a low risk population of pregnant women should not be an alternative to mid-trimester universal CL measurement.</description><identifier>ISSN: 1476-7058</identifier><identifier>EISSN: 1476-4954</identifier><identifier>DOI: 10.1080/14767058.2023.2228448</identifier><identifier>PMID: 37385780</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Abortion, Spontaneous ; Cervix Uteri - diagnostic imaging ; Female ; Humans ; Obesity ; obstetric history ; Pregnancy ; Pregnancy Trimester, Second ; Premature Birth - epidemiology ; preterm delivery ; prevention ; Retrospective Studies ; risk factors ; screening</subject><ispartof>The journal of maternal-fetal & neonatal medicine, 2023-12, Vol.36 (2), p.2228448-2228448</ispartof><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c413t-2057fce4809feb46bf8e8d4c8667880ab82350b0031f84ea57ce7fbe6b6c42423</citedby><cites>FETCH-LOGICAL-c413t-2057fce4809feb46bf8e8d4c8667880ab82350b0031f84ea57ce7fbe6b6c42423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/14767058.2023.2228448$$EPDF$$P50$$Ginformaworld$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/14767058.2023.2228448$$EHTML$$P50$$Ginformaworld$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,27502,27924,27925,59143,59144</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37385780$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soto-Torres, Eleazar E.</creatorcontrib><creatorcontrib>Hernandez-Andrade, Edgar</creatorcontrib><creatorcontrib>Huntley, Erin S.</creatorcontrib><creatorcontrib>Blackwell, Sean C.</creatorcontrib><title>Maternal and obstetrical factors associated with short cervical length at midtrimester in women with no history of preterm delivery</title><title>The journal of maternal-fetal & neonatal medicine</title><addtitle>J Matern Fetal Neonatal Med</addtitle><description>In pregnant women evaluated at 18/0 and 23/6 weeks + days of gestation without history of preterm delivery, a 16.7% detection rate for short cervix ≤15 mm can be achieved by risk factors BMI ≥30, and at least one previous miscarriage. Nevertheless, screening for short cervix by risk factors among low risk women might not be an effective alternative to universal cervical length screening.
To evaluate associations between maternal characteristics and a short cervix in patients without history of preterm delivery, and to determine if these characteristics can predict the presence of a short cervix.
This is a retrospective cohort study that included 18,592 women with singleton pregnancies without history of previous preterm deliveries who underwent universal transvaginal cervical length (TVCL) screening between 18 + 0 and 23 + 6 weeks/days of gestation. A short cervix was defined as a cervical length (CL) ≤25 mm, ≤20 mm, and ≤15 mm. Associations between maternal age, weight, height, body mass index (BMI), previous term deliveries, and history of previous miscarriages, with a short cervix were evaluated using logistic regression models.
The prevalence of a short cervix in our population was: CL ≤25 mm, 2.2% (n = 403); CL ≤20 mm, 1.2% (n = 224); and CL ≤15 mm, 0.9% (n = 161). Women with BMI >30 and/or previous abortions constituted 45.5% of the total population (8463/18,582). Significant associations with short cervix were observed for women with BMI ≥30, and for women with at least one previous abortion (p < .001). Parous women had a significantly lower association with a short cervix than nulliparous women (p < .001). Maternal age or height were not associated with a short cervix. Prediction of short cervix based on presence of any of the following: BMI ≥ 30 or previous abortions showed sensitivities of 55.8% (≤25 mm), 61.6% (≤20 mm), and 63.4% (≤15 mm) with similar specificity (50.1-54.6%) and likelihood ratio positive (1.2-1.5); and prediction based on BMI ≥ 30 and previous abortions showed sensitivities of 11.1% (≤25 mm), 14.7% (≤20 mm), and 16.7% (≤15 mm) with specificity 93%.
Among low risk women for spontaneous preterm delivery, those with a BMI ≥30 and/or previous miscarriages had a significantly increased risk for a short cervix at 18 + 0 and 23 + 6 weeks/days of gestation. Despite these significant associations, screening by maternal risk factors in a low risk population of pregnant women should not be an alternative to mid-trimester universal CL measurement.</description><subject>Abortion, Spontaneous</subject><subject>Cervix Uteri - diagnostic imaging</subject><subject>Female</subject><subject>Humans</subject><subject>Obesity</subject><subject>obstetric history</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, Second</subject><subject>Premature Birth - epidemiology</subject><subject>preterm delivery</subject><subject>prevention</subject><subject>Retrospective Studies</subject><subject>risk factors</subject><subject>screening</subject><issn>1476-7058</issn><issn>1476-4954</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><recordid>eNp9kE1vGyEQhlGVqknT_oRGHHOxO8vHgm-Jon5JqXppz4hlh5poFxzAsXzuHy-unRx7Yhg97zszLyEfOlh2oOFjJ1SvQOolA8aXjDEthH5FLg79hVhJcXaqD9A5eVvKAwDrBMg35JwrrqXScEH-fLcVc7QTtXGkaSgVaw6u_b11NeVCbSnJhUaNdBfqmpZ1ypU6zE__sAnj79a1lc5hbNIZm0WmIdJdmjEeNTHRdSjNbk-Tp5uMDZnpiFN4wrx_R157OxV8f3ovya_Pn37efV3c__jy7e72fuFEx-uCgVTeodCw8jiIfvAa9Sic7nulNdhBMy5hAOCd1wKtVA6VH7AfeieYYPySXB99Nzk9btueZg7F4TTZiGlbDNOcSbVaMWioPKIup1IyerNpp9m8Nx2YQ_7mOX9zyN-c8m-6q9OI7TDj-KJ6DrwBN0cgRJ_ybHcpT6Opdj-l7LONLhTD_z_jL9D2l54</recordid><startdate>20231215</startdate><enddate>20231215</enddate><creator>Soto-Torres, Eleazar E.</creator><creator>Hernandez-Andrade, Edgar</creator><creator>Huntley, Erin S.</creator><creator>Blackwell, Sean C.</creator><general>Taylor & Francis</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20231215</creationdate><title>Maternal and obstetrical factors associated with short cervical length at midtrimester in women with no history of preterm delivery</title><author>Soto-Torres, Eleazar E. ; Hernandez-Andrade, Edgar ; Huntley, Erin S. ; Blackwell, Sean C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c413t-2057fce4809feb46bf8e8d4c8667880ab82350b0031f84ea57ce7fbe6b6c42423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abortion, Spontaneous</topic><topic>Cervix Uteri - diagnostic imaging</topic><topic>Female</topic><topic>Humans</topic><topic>Obesity</topic><topic>obstetric history</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, Second</topic><topic>Premature Birth - epidemiology</topic><topic>preterm delivery</topic><topic>prevention</topic><topic>Retrospective Studies</topic><topic>risk factors</topic><topic>screening</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soto-Torres, Eleazar E.</creatorcontrib><creatorcontrib>Hernandez-Andrade, Edgar</creatorcontrib><creatorcontrib>Huntley, Erin S.</creatorcontrib><creatorcontrib>Blackwell, Sean C.</creatorcontrib><collection>Taylor & Francis Open Access(OpenAccess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soto-Torres, Eleazar E.</au><au>Hernandez-Andrade, Edgar</au><au>Huntley, Erin S.</au><au>Blackwell, Sean C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal and obstetrical factors associated with short cervical length at midtrimester in women with no history of preterm delivery</atitle><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle><addtitle>J Matern Fetal Neonatal Med</addtitle><date>2023-12-15</date><risdate>2023</risdate><volume>36</volume><issue>2</issue><spage>2228448</spage><epage>2228448</epage><pages>2228448-2228448</pages><issn>1476-7058</issn><eissn>1476-4954</eissn><abstract>In pregnant women evaluated at 18/0 and 23/6 weeks + days of gestation without history of preterm delivery, a 16.7% detection rate for short cervix ≤15 mm can be achieved by risk factors BMI ≥30, and at least one previous miscarriage. Nevertheless, screening for short cervix by risk factors among low risk women might not be an effective alternative to universal cervical length screening.
To evaluate associations between maternal characteristics and a short cervix in patients without history of preterm delivery, and to determine if these characteristics can predict the presence of a short cervix.
This is a retrospective cohort study that included 18,592 women with singleton pregnancies without history of previous preterm deliveries who underwent universal transvaginal cervical length (TVCL) screening between 18 + 0 and 23 + 6 weeks/days of gestation. A short cervix was defined as a cervical length (CL) ≤25 mm, ≤20 mm, and ≤15 mm. Associations between maternal age, weight, height, body mass index (BMI), previous term deliveries, and history of previous miscarriages, with a short cervix were evaluated using logistic regression models.
The prevalence of a short cervix in our population was: CL ≤25 mm, 2.2% (n = 403); CL ≤20 mm, 1.2% (n = 224); and CL ≤15 mm, 0.9% (n = 161). Women with BMI >30 and/or previous abortions constituted 45.5% of the total population (8463/18,582). Significant associations with short cervix were observed for women with BMI ≥30, and for women with at least one previous abortion (p < .001). Parous women had a significantly lower association with a short cervix than nulliparous women (p < .001). Maternal age or height were not associated with a short cervix. Prediction of short cervix based on presence of any of the following: BMI ≥ 30 or previous abortions showed sensitivities of 55.8% (≤25 mm), 61.6% (≤20 mm), and 63.4% (≤15 mm) with similar specificity (50.1-54.6%) and likelihood ratio positive (1.2-1.5); and prediction based on BMI ≥ 30 and previous abortions showed sensitivities of 11.1% (≤25 mm), 14.7% (≤20 mm), and 16.7% (≤15 mm) with specificity 93%.
Among low risk women for spontaneous preterm delivery, those with a BMI ≥30 and/or previous miscarriages had a significantly increased risk for a short cervix at 18 + 0 and 23 + 6 weeks/days of gestation. Despite these significant associations, screening by maternal risk factors in a low risk population of pregnant women should not be an alternative to mid-trimester universal CL measurement.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>37385780</pmid><doi>10.1080/14767058.2023.2228448</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abortion, Spontaneous Cervix Uteri - diagnostic imaging Female Humans Obesity obstetric history Pregnancy Pregnancy Trimester, Second Premature Birth - epidemiology preterm delivery prevention Retrospective Studies risk factors screening |
| title | Maternal and obstetrical factors associated with short cervical length at midtrimester in women with no history of preterm delivery |
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