Association between clinical characteristics and second trimester cervical length in singleton pregnancies at Somdejprasangkharach 17 Hospital
Keywords:
cervical length, maternal characteristics, obstetric historyAbstract
Background: Pregnant women with a short cervix are at risk for spontaneous preterm birth. Cervical length measurement is a screening tool to identify women at risk; however, second trimester cervical length measurement in every woman is burdensome.
Objective: To assess possible associations between clinical characteristics/obstetric history and cervical length in the hope of establishing a screening tool for short cervix.
Methods: A cross-sectional study on singleton pregnancies was conducted at Somdejprasangkharach 17 Hospital, in which cervical length was measured during 16-24 weeks of gestational age. Data on obstetric history, clinical characteristics, and cervical length were collected from April 2021 to January 2022. Univariate and multivariate linear regression analyses were performed to assess the relationship.
Results: There were 300 eligible pregnant women. The mean cervical length was 40.77 mm. Using univariate analysis, no association was found between cervical length and maternal height, BMI, and weight, but the cervical length was significantly associated with age, current bodyweight, and obstetric history (p-value = 0.033, 0.035, 0.045, respectively). However, the results from multivariate linear regression analysis demonstrated that age, current body weight, and obstetric history had no significant association with cervical length (p-value = 0.221, 0.094, 0.218, respectively).
Conclusion: Age, weight, height, BMI, and obstetric history were not significantly associated with second-trimester cervical length.
References
Practice Bulletin No. 171: Management of Preterm Labor. Obstetrics and gynecology. 2016;128(4):155-164.
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet. 2012;379(9832):2162-72.
Oskovi Kaplan ZA, Ozgu-Erdinc AS. Prediction of preterm birth: maternal characteristics, ultrasound markers, and biomarkers: an updated overview. Journal of pregnancy. 2018;2018.
Wanitpongpan P. Cervical length at mid- trimester in Thai women with normal singleton pregnancies. Siriraj Medical Journal. 2015;67(1).
Son M, Miller ES, editors. Predicting preterm birth: cervical length and fetal fibronectin. Seminars in perinatology; 2017: Elsevier.
Glover AV, Manuck TA, editors. Screening for spontaneous preterm birth and resultant therapies to reduce neonatal morbidity and mortality: A review. Seminars in Fetal and Neonatal Medicine; 2018: Elsevier.
Crane J, Hutchens D. Use of transvaginal ultrasonography to predict preterm birth in women with a history of preterm birth. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2008;32(5):640-5.
Medicine FWGOBPIM-F, Gynecology Ifo, Obstetrics. Best practice in maternal-fetal medicine. Int J Gynaecol Obstet. 2015;128(1):80-2.
Practice Bulletin No. 234: Prediction and Prevention of Spontaneous Preterm Birth. Obstetrics and Gynecology. 2021;138(2):65-90.
Committee SfM-FMP. Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. American journal of obstetrics and gynecology. 2012;206(5):376-86.
ราชวิทยาลัยสูตินรีแพทย์แห่งประเทศไทย. แนวทางเวชปฏิบัติราชวิทยาลัยสูตินรีแพทย์ แห่งประเทศไทย. ฉบับนิพน์และเรียบเรียง ครั้งที่ 3. พิมพ์ครั้งที่1. กรุงเทพฯ: พี.เอ.ลีฟ วิ่ง; 2565. หน้า 227-251
Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH. Progesterone and the risk of preterm birth among women with a short cervix. New England Journal of Medicine. 2007;357(5):462-9.
Hassan S, Romero R, Vidyadhari D, Fusey S, Baxter J, Khandelwal M, et al. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo‐controlled trial. Ultrasound in Obstetrics & Gynecology. 2011;38(1):18-31.
Cahill AG, Odibo AO, Caughey AB, Stamilio DM, Hassan SS, Macones GA, et al. Universal cervical length screening and treatment with vaginal progesterone to prevent preterm birth: a decision and economic analysis. American journal of obstetrics and gynecology. 2010;202(6):548. e1-. e8.
Werner EF, Hamel MS, Orzechowski K, Berghella V, Thung SF. Cost-effectiveness of transvaginal ultrasound cervical length screening in singletons without a prior preterm birth: an update. American journal of obstetrics and gynecology. 2015;213(4):554. e1-. e6.
Facco FL, Simhan HN. Short ultrasonographic cervical length in women with low-risk obstetric history. Obstetrics & Gynecology. 2013;122(4):858-62.
Orzechowski KM, Boelig R, Nicholas SS, Baxter J, Berghella V. Is universal cervical length screening indicated in women with prior term birth? American journal of obstetrics and gynecology. 2015;212(2):234. e1-. e5.
Masters HR, Warshak C, Sinclair S, Rountree S, DeFranco E. Time required to complete transvaginal cervical length in women receiving universal cervical length screening for preterm birth prevention. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1-5.
Woraboot W, Wanitpongpan P, Phaophan A. Correlation between lower uterine wall thickness measured by transabdominal ultrasonography and cervical length measured by transvaginal ultrasonography in Thai pregnant women. J Chin Med Assoc. 2019 Jan;82(1):50-54.
Van der Ven A, Van Os M, Kleinrouweler C, De Groot C, Haak M, Mol B, et al. Is cervical length associated with maternal characteristics? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015;188:12-6.
Miller ES, Tita AT, Grobman WA. Second-trimester cervical length screening among asymptomatic women: an evaluation of risk-based strategies. Obstetrics & Gynecology. 2015;126(1):61-6.
Palatnik A, Miller ES, Son M, Kominiarek MA. Association among maternal obesity, cervical length, and preterm birth. American journal of perinatology. 2017;34(05):471-9.
Hendler I, Goldenberg RL, Mercer BM, Iams JD, Meis PJ, Moawad AH, et al. The Preterm Prediction Study: association between maternal body mass index and spontaneous and indicated preterm birth. American journal of obstetrics and gynecology. 2005;192(3):882-6.
Liabsuetrakul T, Suntharasaj T, Suwanrath C, Leetanaporn R, Rattanaprueksachart R, Tuntiseranee P. Serial transtibial sonographic measurement of cervical dimensions between 24 and 34 weeks gestation in pregnant Thai women. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002;20(2):168-73.
Cho S-H, Park KH, Jung EY, Joo JK, Jang JA, Yoo H-N. Maternal characteristics, short mid-trimester cervical length, and preterm delivery. Journal of Korean medical science. 2017;32(3):488-94.
Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, N.J.: L. Erlbaum Associates; 1988. p.412.
Kovavisarach E, Sukontaman W. Nomogram of Cervical Length at Mid-trimester in Normal Thai Pregnant Women. JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND. 2018;101(2):31.
Tongsong T, Kamprapanth P, Pitaksakorn J. Cervical length in normal pregnancy as measured by transvaginal sonography. International Journal of Gynecology & Obstetrics. 1997;58(3):313-5.
Maerdan M, Shi C, Zhang X, Fan L. The prevalence of short cervix between 20 and 24 weeks of gestation and vaginal progesterone for prolonging of gestation. The Journal of Maternal-Fetal & Neonatal Medicine. 2017;30(14):1646-9.
Sundtoft I, Sommer S, Uldbjerg N. Cervical collagen concentration within 15 months after delivery. American Journal of Obstetrics and Gynecology. 2011;205(1):59.e1-59.e3.
Souka A, Papastefanou I, Michalitsi V, Papadopoulos G, Kassanos D. A predictive model of the short cervix at 20–24 weeks using first‐trimester cervical length measurement and maternal history. Prenatal diagnosis. 2011;31(2):202-6.
Albayrak M, Ozdemir I, Koc O, Coskun E. Can maternal height predict shorter cervical length in asymptomatic low-risk pregnant women? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2011;157(2):161-5.
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