The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta‐analysis

• Published in: BJOG : an international journal of obstetrics and gynaecology 2016-05, Vol.123 (6), p.877-884
• Main Authors: Kindinger, LM, Poon, LC, Cacciatore, S, MacIntyre, DA, Fox, NS, Schuit, E, Mol, BW, Liem, S, Lim, AC, Serra, V, Perales, A, Hermans, F, Darzi, A, Bennett, P, Nicolaides, KH, Teoh, TG
• Format: Article
• Language: English
• Subjects: Cervical length; Cervical Length Measurement; Cervix Uteri - anatomy & histology; Cervix Uteri - diagnostic imaging; Female; Gestational Age; Humans; individual patient meta‐analysis; Meta-analysis; Predictive Value of Tests; Pregnancy; Pregnancy, Twin; Premature birth; Premature Birth - diagnostic imaging; prematurity; preterm birth; twin pregnancy; Twins; Ultrasonic imaging
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.13575

Objective To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy. Design Individual patient data (IPD) meta‐analysis. Setting International multicentre study. Population Asymptomatic twin pregnancy. Methods MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28+0, 28+1 to 32+0, 32+1 to 36+0, and ≥36+1 weeks as a function of GA at screening and CL measurements. Main outcome measures Predicted probabilities for preterm birth at ≤28+0, 28+1 to 32+0, and 32+1 to 36+0. Results A total of 6188 CL measurements were performed on 4409 twin pregnancies in 12 studies. Both GA at screening and CL had a significant and non‐linear effect on GA at birth. The best prediction of birth at ≤28+0 weeks was provided by screening at ≤18+0 weeks (P