Development of children born to women with twin pregnancies treated with cervical pessary or vaginal progesterone: Follow‐up of a randomized controlled trial

Introduction Preterm birth is the most common cause of neonatal morbidity and mortality. Women with twin pregnancies and a short cervical length are at high risk for preterm birth. Vaginal progesterone and cervical pessary have been proposed as potential strategies to reduce preterm birth in this hi...

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Published in:Acta obstetricia et gynecologica Scandinavica 2023-05, Vol.102 (5), p.626-634
Main Authors: Tran, Van T. T., Nguyen, Nghia A., Nguyen, Nam T., Vo, Thu T. M., Uong, Truong S., Nguyen, Hau T., Nguyen, Ngan T., Pham, Toan D., Nguyen, Minh H. N., Vuong, Lan N., Mol, Ben W., Dang, Vinh Q.
Format: Article
Language:English
Subjects:
Administration, Intravaginal
ASQ‐3
cervical pessary
Cervix Uteri
Child
Clinical outcomes
Clinical trials
developmental outcomes
Female
Follow-Up Studies
Humans
Infant, Newborn
Original
Original s
Perinatal Death
Pessaries
Pregnancy
Pregnancy, Twin
Premature birth
Premature Birth - prevention & control
Progesterone
Questionnaires
red flag signs
twin pregnancy
Vagina
vaginal progesterone
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Summary:Introduction Preterm birth is the most common cause of neonatal morbidity and mortality. Women with twin pregnancies and a short cervical length are at high risk for preterm birth. Vaginal progesterone and cervical pessary have been proposed as potential strategies to reduce preterm birth in this high‐risk population. Therefore, we aimed to compare the effectiveness of cervical pessary and vaginal progesterone in improving developmental outcomes of children born to women with twin pregnancies and mid‐trimester short cervical length. Material and methods This was a follow‐up study (NCT04295187) of all children at 24 months of age, born from women treated with cervical pessary or progesterone to prevent preterm birth in a randomized controlled trial (NCT02623881). We used a validated Vietnamese version of Ages & Stages Third Edition Questionnaires (ASQ‐3) and a red flag questionnaire. In surviving children, we compared the mean ASQ‐3 scores, abnormal ASQ‐3 scores, the number of children with any abnormal ASQ‐3 scores and red flag signs between the two groups. We reported the composite outcome of perinatal death or survival with any abnormal ASQ‐3 score in offspring. These outcomes were also calculated in a subgroup of women with a cervical length ≤28 mm (
ISSN:0001-6349
1600-0412
DOI:10.1111/aogs.14545