Evidence map›Paper›PMID 40336574›Full record

ArticleBMJ medicine2025

Prognostic value of cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy: meta-analysis of individual participant data.

Kelly Margaret Hughes, Mason Aberoumand, Anna Lene Seidler, Phoebe Swan, Mona Aboulghar, Maria de Lourdes Brizot, Clifton Brock, Marta Benito Vielba, Nathan Fox, Cynthia Gyamfi-Bannerman and 12 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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

22 authors.

Kelly Margaret HughesDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.ORCID 0000-0003-3790-7741
Mason AberoumandNHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia.
Anna Lene SeidlerNHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia.
Phoebe SwanDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.
Mona AboulgharDepartment of Obstetrics and Gynaecology, Cairo University, Giza, Egypt.
Maria de Lourdes BrizotDisciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Clifton BrockMidwest Fetal Care Center, Children's Minnesota - Minneapolis, Minneapolis, Minnesota, USA.
Marta Benito VielbaDepartment of Obstetrics and Gynecology, Miguel Servet University Hospital, Zaragoza, Spain.
Nathan FoxDepartment of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Cynthia Gyamfi-BannermanDepartments of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, California, USA.
Lindsay KindingerKing Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia.
Giorgio PaganiMaternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, ASST Papa Giovanni XXIII, Bergamo, Italy.
Alfredo Perales MarinDepartment of Obstetrics, La Fe University and Polytechnic Hospital, Valencia, Spain.
Viola SeravalliDepartment of Health Sciences, University of Florence, Firenze, Italy.
Mariarosaria Di TommasoDepartment of Health Sciences, University of Florence, Firenze, Italy.
Omer WeitznerDepartment of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
Katharina WordaDepartment of Obstetrics and Gynecology, Medical University of Vienna, Wien, Austria.
Lukas StaubNHMRC Clinical Trial Centre, University of Sydney, Sydney, New South Wales, Australia.
Shaun BrenneckeDepartment of Obstetrics and Gynaecology, University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia.
Shakila ThangaratinamUniversity of Birmingham Institute of Metabolism and Systems Research, Birmingham, UK.
Ben W MolDepartment of Obstetrics and Gynaecology, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia.ORCID 0000-0001-8337-550X
Rui WangDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.ORCID 0000-0002-6622-8134

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To quantify the prognostic value of mid-trimester cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy and to assess whether other factors may modify any association. Designs: A two stage meta-analysis of individual participant data in a Cox proportional hazard model was performed using cervical length as a continuous variable. Data sources: Medline, Embase, Cochrane, and LILACS, among others, were searched to identify eligible studies; the search was from 1 January 2000 to 30 September 2020. Risk of bias was assessed with the QUIPS tool. Studies were from eight countries between 2001 and 2018. Eligibility criteria: Individual participant data were sought for eligible studies that reported mid-trimester (defined between 16 and 26 weeks) transvaginal sonographic cervical length and also gestational age at birth in asymptomatic women with twin pregnancy. The primary outcome was spontaneous preterm birth before 37 weeks. Results: Among 29 eligible studies, authors of 17 studies provided individual participant data for 6437 women with a twin pregnancy (69.1% of individual participant data). Mean cervical length measurement was 39 mm (SD=9, range 1-74 mm). 2889 women (44.9%) delivered before 37 weeks' gestation, and 934 (14.9%) delivered before 34 weeks. Each 1 mm increase in cervical length was associated with a 4.0% reduction in the rate of spontaneous preterm birth before 37 weeks (hazard ratio 0.96 (95% confidence interval 0.95 to 0.97)), and a 6.8% reduction in the rate of spontaneous preterm birth before 34 weeks' gestation (0.93 (0.92 to 0.95)). The prognostic value remained stable in models adjusting for different sets of variables. Conclusion: The prognostic value of cervical length for spontaneous preterm birth in twin pregnancy is on a continuous scale. No specific cervical length has been identified that can reliably predict or exclude all spontaneous preterm births. Study registration: CRD42020146987.

Indexed as

Diagnostic imagingPregnancy complicationsPrenatal careUltrasonography

Identifiers

PMID40336574
PMCPMC12056617

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.