Serial cervical‐length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37weeks' gestation
ObjectiveTo assess whether repeat cervical‐length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth.MethodsThis was a secondary analysis of a randomized controlled trial of maintenance tocolysi...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2021-02, Vol.57 (2), p.298-304 |
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| container_title | Ultrasound in obstetrics & gynecology |
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| creator | Chiossi, G Facchinetti, F Vergani, P M Di Tommaso Marozio, L Acaia, B Pignatti, L Locatelli, A Spitaleri, M Benedetto, C Zaina, B D'Amico, R |
| description | ObjectiveTo assess whether repeat cervical‐length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth.MethodsThis was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL |
| doi_str_mv | 10.1002/uog.22188 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest</sourceid><recordid>TN_cdi_proquest_journals_2484295752</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2484295752</sourcerecordid><originalsourceid>FETCH-proquest_journals_24842957523</originalsourceid><addsrcrecordid>eNqNzD1OxDAQBWALgUT4KbjBSBRUWRznv0YgeuhXJplkvTh2mHGC6DgCB-B0nASvxAGoRnrveyPEVSY3mZTqdvHjRqmsaY5EkhVVm8palscikW0l07pq1ak4Y95LKasirxLx_YRktIUOaTWdtj-fXxbdGHYwoeaFcEIXGPQQkGAwxAFwNux7BD9A2BHqgA57mAkjmcDqF09gppn8ioe0N10w3h04z94F7dAvDD1asyJ9RGLiIHjI63fEV76BETnow-ZCnAzaMl7-3XNx_XD_fPeYxudvS1TbvV_IxWqriqZQbVmXKv-f-gWOYGM0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2484295752</pqid></control><display><type>article</type><title>Serial cervical‐length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37weeks' gestation</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Chiossi, G ; Facchinetti, F ; Vergani, P ; M Di Tommaso ; Marozio, L ; Acaia, B ; Pignatti, L ; Locatelli, A ; Spitaleri, M ; Benedetto, C ; Zaina, B ; D'Amico, R</creator><creatorcontrib>Chiossi, G ; Facchinetti, F ; Vergani, P ; M Di Tommaso ; Marozio, L ; Acaia, B ; Pignatti, L ; Locatelli, A ; Spitaleri, M ; Benedetto, C ; Zaina, B ; D'Amico, R</creatorcontrib><description>ObjectiveTo assess whether repeat cervical‐length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth.MethodsThis was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow‐up evaluation could predict spontaneous delivery prior to 37 weeks of gestation.ResultsOf 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2–9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1–7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3–22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks.ConclusionsWomen who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow‐up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.22188</identifier><language>eng</language><publisher>London: Wiley Subscription Services, Inc</publisher><subject>Birth ; Childbirth & labor ; Gestation ; Gynecology ; Health risks ; Labor ; Obstetrics ; Premature birth ; Regression analysis ; Resource utilization ; Risk ; Risk assessment ; Secondary analysis ; Ultrasonic imaging ; Ultrasound</subject><ispartof>Ultrasound in obstetrics & gynecology, 2021-02, Vol.57 (2), p.298-304</ispartof><rights>Copyright © 2021 ISUOG. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Chiossi, G</creatorcontrib><creatorcontrib>Facchinetti, F</creatorcontrib><creatorcontrib>Vergani, P</creatorcontrib><creatorcontrib>M Di Tommaso</creatorcontrib><creatorcontrib>Marozio, L</creatorcontrib><creatorcontrib>Acaia, B</creatorcontrib><creatorcontrib>Pignatti, L</creatorcontrib><creatorcontrib>Locatelli, A</creatorcontrib><creatorcontrib>Spitaleri, M</creatorcontrib><creatorcontrib>Benedetto, C</creatorcontrib><creatorcontrib>Zaina, B</creatorcontrib><creatorcontrib>D'Amico, R</creatorcontrib><title>Serial cervical‐length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37weeks' gestation</title><title>Ultrasound in obstetrics & gynecology</title><description>ObjectiveTo assess whether repeat cervical‐length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth.MethodsThis was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow‐up evaluation could predict spontaneous delivery prior to 37 weeks of gestation.ResultsOf 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2–9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1–7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3–22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks.ConclusionsWomen who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow‐up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology</description><subject>Birth</subject><subject>Childbirth & labor</subject><subject>Gestation</subject><subject>Gynecology</subject><subject>Health risks</subject><subject>Labor</subject><subject>Obstetrics</subject><subject>Premature birth</subject><subject>Regression analysis</subject><subject>Resource utilization</subject><subject>Risk</subject><subject>Risk assessment</subject><subject>Secondary analysis</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqNzD1OxDAQBWALgUT4KbjBSBRUWRznv0YgeuhXJplkvTh2mHGC6DgCB-B0nASvxAGoRnrveyPEVSY3mZTqdvHjRqmsaY5EkhVVm8palscikW0l07pq1ak4Y95LKasirxLx_YRktIUOaTWdtj-fXxbdGHYwoeaFcEIXGPQQkGAwxAFwNux7BD9A2BHqgA57mAkjmcDqF09gppn8ioe0N10w3h04z94F7dAvDD1asyJ9RGLiIHjI63fEV76BETnow-ZCnAzaMl7-3XNx_XD_fPeYxudvS1TbvV_IxWqriqZQbVmXKv-f-gWOYGM0</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Chiossi, G</creator><creator>Facchinetti, F</creator><creator>Vergani, P</creator><creator>M Di Tommaso</creator><creator>Marozio, L</creator><creator>Acaia, B</creator><creator>Pignatti, L</creator><creator>Locatelli, A</creator><creator>Spitaleri, M</creator><creator>Benedetto, C</creator><creator>Zaina, B</creator><creator>D'Amico, R</creator><general>Wiley Subscription Services, Inc</general><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope></search><sort><creationdate>20210201</creationdate><title>Serial cervical‐length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37weeks' gestation</title><author>Chiossi, G ; Facchinetti, F ; Vergani, P ; M Di Tommaso ; Marozio, L ; Acaia, B ; Pignatti, L ; Locatelli, A ; Spitaleri, M ; Benedetto, C ; Zaina, B ; D'Amico, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_journals_24842957523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Birth</topic><topic>Childbirth & labor</topic><topic>Gestation</topic><topic>Gynecology</topic><topic>Health risks</topic><topic>Labor</topic><topic>Obstetrics</topic><topic>Premature birth</topic><topic>Regression analysis</topic><topic>Resource utilization</topic><topic>Risk</topic><topic>Risk assessment</topic><topic>Secondary analysis</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chiossi, G</creatorcontrib><creatorcontrib>Facchinetti, F</creatorcontrib><creatorcontrib>Vergani, P</creatorcontrib><creatorcontrib>M Di Tommaso</creatorcontrib><creatorcontrib>Marozio, L</creatorcontrib><creatorcontrib>Acaia, B</creatorcontrib><creatorcontrib>Pignatti, L</creatorcontrib><creatorcontrib>Locatelli, A</creatorcontrib><creatorcontrib>Spitaleri, M</creatorcontrib><creatorcontrib>Benedetto, C</creatorcontrib><creatorcontrib>Zaina, B</creatorcontrib><creatorcontrib>D'Amico, R</creatorcontrib><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chiossi, G</au><au>Facchinetti, F</au><au>Vergani, P</au><au>M Di Tommaso</au><au>Marozio, L</au><au>Acaia, B</au><au>Pignatti, L</au><au>Locatelli, A</au><au>Spitaleri, M</au><au>Benedetto, C</au><au>Zaina, B</au><au>D'Amico, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serial cervical‐length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37weeks' gestation</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><date>2021-02-01</date><risdate>2021</risdate><volume>57</volume><issue>2</issue><spage>298</spage><epage>304</epage><pages>298-304</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><abstract>ObjectiveTo assess whether repeat cervical‐length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth.MethodsThis was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow‐up evaluation could predict spontaneous delivery prior to 37 weeks of gestation.ResultsOf 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2–9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1–7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3–22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks.ConclusionsWomen who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow‐up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology</abstract><cop>London</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/uog.22188</doi></addata></record> |
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| subjects | Birth Childbirth & labor Gestation Gynecology Health risks Labor Obstetrics Premature birth Regression analysis Resource utilization Risk Risk assessment Secondary analysis Ultrasonic imaging Ultrasound |
| title | Serial cervical‐length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37weeks' gestation |
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