Evidence map›Paper›PMID 41053617›Full record

SynthesisBMC pregnancy and childbirth2025

First-trimester cervical length screening and the risk of preterm birth: a systematic review and meta-analysis.

Sedigheh Hantoushzadeh, Nafiseh Saedi, Kyana Jafarabady, Mohadese Dashtkoohi, Mohammad Haddadi, Nasim Eshraghi, Nikan Zargarzadeh, Hiba Mustafa, Alireza Shamshirsaz

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

9 authors.

Sedigheh HantoushzadehVali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Nafiseh SaediDepartment of Obstetrics and Gynecology, Yas University Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Kyana JafarabadyStudent Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
Mohadese DashtkoohiVali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad HaddadiVali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Nasim EshraghiVali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Nikan ZargarzadehDivision of Fetal Medicine and Surgery, Maternal Fetal Care Center, Boston Children's Hospital, Harvard School of Medicine, Boston, MA, USA.
Hiba MustafaDivision of Maternal-Fetal Medicine, The Fetal Center at Riley Children's and Indiana University Health, Indiana University School of Medicine, Riley Children's Hospital, Indianapolis, IN, USA.
Alireza ShamshirsazDivision of Fetal Medicine and Surgery, Maternal Fetal Care Center, Boston Children's Hospital, Harvard School of Medicine, Boston, MA, USA. Alireza.Shamshirsaz@childrens.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe clinical utility of first-trimester cervical length (CL) measurement remains uncertain. This systematic review and meta-analysis aimed to evaluate the association between first-trimester CL measurement and preterm birth (PTB) risk.

methodsThis study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (CRD42023462610). A comprehensive search was conducted across four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) until January 29, 2024, using MeSH terms and keywords. We included randomized controlled trials, comparative observational studies, and retrospective studies that examined first-trimester CL measurement and reported PTB as a primary or secondary outcome. Two independent reviewers conducted study selection and data extraction, resolving discrepancies through discussion. Risk of bias was assessed using the Newcastle-Ottawa Scale. A meta-analysis using a random-effects model was conducted, with heterogeneity evaluated via I² statistics.

resultsFive studies comprising 16,053 pregnancies were included. CL was significantly shorter in individuals delivering before 34 weeks compared to those delivering at or after 34 weeks, with a pooled mean difference of -0.59 mm (95% confidence interval [CI]: -1.14 to -0.04; p = 0.04; I²=72.56%). Similarly, those delivering before 37 weeks had a significantly shorter CL than those delivering at or after 37 weeks, with a pooled mean difference of -0.23 mm (95% CI: -0.43 to -0.03; p = 0.02; I²=76.26%).

conclusionFirst-trimester CL measurement is significantly associated with PTB risk. However, due to study heterogeneity and physiological variability in early pregnancy, its clinical utility as a predictive tool remains uncertain. Further research with standardized protocols and larger cohorts is needed to assess its role in screening and early intervention strategies for both low- and high-risk pregnancies.

Indexed as

Cervical Length MeasurementCervix UteriPregnancy Trimester, FirstPremature BirthFemaleHumansPregnancyRisk FactorsCervical lengthFirst trimesterMeta-analysisPremature birthSystematic review

Identifiers

PMID41053617
PMCPMC12502216

What OpenQuestion holds

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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.