Evidence map›Paper›PMID 36949530›Full record

Trial reportReproductive health2023

Association between cervical length and gestational age at birth in singleton pregnancies: a multicentric prospective cohort study in the Brazilian population.

Thais Valéria Silva, Anderson Borovac-Pinheiro, José Guilherme Cecatti, Ben Willem Mol, Fabricio Silva Costa, Marcelo Santucci França, Renato Teixeira Souza, Roland Devlieger, Renato Passini, Rodolfo Carvalho Pacagnella and 1 more

Open access · goldFull text readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Reproductive health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 4 countries.

Thais Valéria SilvaDepartment of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, Brazil.
Anderson Borovac-PinheiroDepartment of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, Brazil.
José Guilherme CecattiDepartment of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, Brazil.
Ben Willem MolDepartment of Obstetrics and Gynaecology, Monash University, Victoria, Australia.
Fabricio Silva CostaMaternal Fetal Medicine Unit, Gold Coast University Hospital and School of Medicine, Griffith University, Southport, Australia.
Marcelo Santucci FrançaScreening and Prevention of Preterm Birth Sector, Fetal Medicine Discipline, Obstetrics Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil.
Renato Teixeira SouzaDepartment of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, Brazil.
Roland DevliegerDepartment of Obstetrics and Gynaecology, University Hospitals KU Leuven, Louvain, Belgium.
Renato PassiniDepartment of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, Brazil.
Rodolfo Carvalho PacagnellaDepartment of Obstetrics and Gynecology, School of Medicine, University of Campinas, Campinas, Brazil. rodolfop@unicamp.br.
P5 working group
Universidade Estadual de Campinas (UNICAMP) · BRGriffith University · AUKU Leuven · BEUniversidade Federal de São Paulo · BRUniversity of Aberdeen · GB

Funding

Bill and Melinda Gates Foundation OPP1107597Conselho Nacional de Desenvolvimento Científico e Tecnológico 401615/20138Coordenação de Aperfeiçoamento Pessoal de Nível Superior-CAPES 001
6 · The paper itself

Abstract

backgroundShort cervical length measured during the second trimester of pregnancy is an important risk factor for spontaneous preterm birth (sPTB). The aim of this study is to identify the association between mid-pregnancy cervical length (CL) and gestational age at birth in asymptomatic singleton pregnant women.

methodsThis is a prospective cohort study involving singleton pregnant women who participated in the screening phase of a Brazilian multicenter randomized controlled trial (P5 trial) between July 2015 and March 2019. Transvaginal ultrasound to measure CL was performed from 18 to 22 + 6 weeks. Women with CL ≤ 30 mm received vaginal progesterone (200 mg/day) until 36 weeks' gestation. For this analysis we considered all women with CL ≤ 30 mm receiving progesterone and a random selection of women with CL > 30 mm, keeping the populational distribution of CL. We obtained prognostic effectiveness data (area under receive operating characteristic curve (AUC), sensitivity and specificity and estimated Kaplan-Meier curves for preterm birth using different CL cutoff points.

resultsWe report on 3139 women and identified a negative association between cervical length and sPTB. CL ≤ 25 mm was associated with sPTB < 28, sPTB < 34 and sPTB < 37 weeks, whereas a CL 25-30 mm was directly associated with late sPTB. CL by transvaginal ultrasound presented an AUC of 0.82 to predict sPTB < 28 weeks and 0.67 for sPTB < 34 weeks. Almost half of the sPTB occurred in nulliparous women and CL ≤ 30 mm was associated with sPTB at < 37 weeks (OR = 7.84; 95%CI = 5.5-11.1). The number needed to screen to detect one sPTB < 34 weeks in women with CL ≤ 25 mm is 121 and we estimated that 248 screening tests are necessary to prevent one sPTB < 34 weeks using progesterone prophylaxis.

conclusionsCL measured by transvaginal ultrasound should be used to predict sPTB < 34 weeks. Women with CL ≤ 30 mm are at increased risk for late sPTB.

Indexed as

Premature BirthBrazilFemaleGestational AgeHumansInfant, NewbornParturitionPregnancyProgesteroneProspective StudiesProgesteroneCervical lengthNumber needed to screenPregnancyPreterm birthShort cervix

Identifiers

PMID36949530
PMCPMC10035243
OpenAlexW4360600476

What OpenQuestion holds

Textfull text, public
LicenceCC BY
reference markers read1
measurements read32
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.