Timing of mid-trimester cervical length shortening in high-risk women
Copyright (c) 2008 ISUOG..
OBJECTIVE: To examine the natural history of cervical length shortening in women who had experienced at least one prior spontaneous preterm birth at between 17+0 and 33+6 weeks' gestation.
METHODS: This was an analysis of prerandomization data from the multicenter Vaginal Ultrasound Cerclage Trial. Serial cervical length was measured by transvaginal sonography in 1014 high-risk women at 16+0 to 22+6 weeks. We performed survival analyses in which the outcome was cervical length shortening<25 mm and data were censored if this did not occur before 22+6 weeks' gestation. The incidence of cervical length shortening and the time to shortening were compared for women whose earliest prior preterm birth was in the mid-trimester, defined as <24 weeks, vs. those at weeks 24-33. Similar comparisons were performed based on each patient's most recent birth history.
RESULTS: Time to cervical length shortening by survival analysis was significantly shorter (hazard ratio (HR)=2.2, P<0.0001) and the relative risk (RR) of shortening significantly higher (RR=1.8, P<0.0001) for women whose earliest prior spontaneous preterm birth was at <24 weeks. A larger effect was observed for women whose most recent birth was at <24 weeks (HR=2.8, P<0.0001; RR=2.1, P<0.0001). The observed hazard ratios remained significant after adjusting for confounders in a multivariable Cox proportional hazards model.
CONCLUSION: Women with a prior spontaneous preterm birth at <24 weeks are at a higher risk of cervical shortening, and do so at a higher rate and at an earlier gestational age, than do women with a later preterm birth history.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2009 |
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| Erschienen: |
2009 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology - 33(2009), 1 vom: 28. Jan., Seite 70-5 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Szychowski, J M [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 22.09.2009 Date Revised 20.10.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1002/uog.6283 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM185083846 |
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| 100 | 1 | |a Szychowski, J M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Timing of mid-trimester cervical length shortening in high-risk women |
| 264 | 1 | |c 2009 | |
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| 500 | |a Date Completed 22.09.2009 | ||
| 500 | |a Date Revised 20.10.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright (c) 2008 ISUOG. | ||
| 520 | |a OBJECTIVE: To examine the natural history of cervical length shortening in women who had experienced at least one prior spontaneous preterm birth at between 17+0 and 33+6 weeks' gestation | ||
| 520 | |a METHODS: This was an analysis of prerandomization data from the multicenter Vaginal Ultrasound Cerclage Trial. Serial cervical length was measured by transvaginal sonography in 1014 high-risk women at 16+0 to 22+6 weeks. We performed survival analyses in which the outcome was cervical length shortening<25 mm and data were censored if this did not occur before 22+6 weeks' gestation. The incidence of cervical length shortening and the time to shortening were compared for women whose earliest prior preterm birth was in the mid-trimester, defined as <24 weeks, vs. those at weeks 24-33. Similar comparisons were performed based on each patient's most recent birth history | ||
| 520 | |a RESULTS: Time to cervical length shortening by survival analysis was significantly shorter (hazard ratio (HR)=2.2, P<0.0001) and the relative risk (RR) of shortening significantly higher (RR=1.8, P<0.0001) for women whose earliest prior spontaneous preterm birth was at <24 weeks. A larger effect was observed for women whose most recent birth was at <24 weeks (HR=2.8, P<0.0001; RR=2.1, P<0.0001). The observed hazard ratios remained significant after adjusting for confounders in a multivariable Cox proportional hazards model | ||
| 520 | |a CONCLUSION: Women with a prior spontaneous preterm birth at <24 weeks are at a higher risk of cervical shortening, and do so at a higher rate and at an earlier gestational age, than do women with a later preterm birth history | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 700 | 1 | |a Owen, J |e verfasserin |4 aut | |
| 700 | 1 | |a Hankins, G |e verfasserin |4 aut | |
| 700 | 1 | |a Iams, J |e verfasserin |4 aut | |
| 700 | 1 | |a Sheffield, J |e verfasserin |4 aut | |
| 700 | 1 | |a Perez-Delboy, A |e verfasserin |4 aut | |
| 700 | 1 | |a Berghella, V |e verfasserin |4 aut | |
| 700 | 1 | |a Wing, D A |e verfasserin |4 aut | |
| 700 | 1 | |a Guzman, E R |e verfasserin |4 aut | |
| 700 | 0 | |a Vaginal Ultrasound Cerclage Trial Consortium |e verfasserin |4 aut | |
| 700 | 1 | |a Hauth, John C |e investigator |4 oth | |
| 700 | 1 | |a Ramin, Susan |e investigator |4 oth | |
| 700 | 1 | |a Silver, Richard |e investigator |4 oth | |
| 700 | 1 | |a Egerman, Robert |e investigator |4 oth | |
| 700 | 1 | |a Tomlinson, Mark |e investigator |4 oth | |
| 700 | 1 | |a Gordon, Mike |e investigator |4 oth | |
| 700 | 1 | |a How, Helen |e investigator |4 oth | |
| 700 | 1 | |a Knudtson, Eric |e investigator |4 oth | |
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