Association between cervical length and gestational age at birth in singleton pregnancies : a multicentric prospective cohort study in the Brazilian population
Thais Valériasilva, 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
ARTIGO
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Agradecimentos: We would like to thank all P5 working group: Allan R Hatanaka, Department of Obstetrics, Federal University of São Paulo (UNIFESP). Amanda Dantas, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Antonio Fernandes Moron, Department of...
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Agradecimentos: We would like to thank all P5 working group: Allan R Hatanaka, Department of Obstetrics, Federal University of São Paulo (UNIFESP). Amanda Dantas, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Antonio Fernandes Moron, Department of Obstetrics, Federal University of São Paulo (UNIFESP). Carlos Augusto Santos Menezes, Maternity Climério de Oliveira—School of Medicine of Bahia-UFBa. Cláudio Sérgio Medeiros Paiva, Department of Obstetrics and Gynecology, Federal University of Paraiba. Cristhiane B Marques, Center for Reproductive Research of Campinas-Cemicamp. Cynara Maria Pereira, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Daniela dos Santos Lopes Homenko, São Vicente City Hall. Djacyr Magna Cabral Paiva, Maternal and Child Department, Federal University of Paraíba-UFPB. Elaine Christine Dantas Moisés, Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, University of São Paulo. Enoch Quinderé Sá Barreto, Maternity Vila Nova Cachoeirinha. Felipe Soares, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Fernando Maia Peixoto-Filho , Fernandes Figueira Institute, Oswaldo Cruz Foundation. Francisco Edson de Lucena Feitosa, Department of Women, Children and Adolescents Health at the Federal University of Ceará. Francisco Herlanio Costa Carvalho, Department of Women, Children and Adolescents Health a Federal University of Ceará. Jessica Scremin Boechem, Fernandes Figueira Institute, Oswaldo Cruz Foundation. João Renato Benini-Junior, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. José Airton Oliveira Lima, São Vicente City Hall. Juliana P. Argenton, University of Campinas. Kaline F Marquart, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Karayna Gil Fernandes, School of Medicine of Jundiaí. Kleber Cursino Andrade, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Leila Katz, Institute of Integral Medicine Fernando Figueira (IMIP). Maíra Rossmann Machado, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Marcelo L Nomura, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Marcelo Marques Souza Lima, Hospital Dom Malan-IMIP. Marcos Nakamura-Pereira, Fernandes Figueira Institute, Oswaldo Cruz Foundation. Maria Julia Miele, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Maria Laura Costa, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Mário Dias Correia Jr, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Minas Gerais. Nathalia Ellovitch, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Nelson Sass, Department of Obstetrics, Federal University of São Paulo (UNIFESP). Rodrigo Pauperio Soares Camargo, School of Medicine of Jundiaí. Sabrina de Oliveira Silva Savazoni, São Vicente City Hall. Samira El Maerrawi Tebecherane Haddad, UNOESTE / Guarujá Medical School; São Vicente City Hall. Sérgio Martins-Costa, Department of Gynecology and Obstetrics, School of Medicine, Federal University of Rio Grande do Sul. Silvana F Bento, Reproductive Research Center of Campinas-Cemicamp. Silvana Maria Quintana, Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, University of São Paulo. Stéphanno Gomes Pereira Sarmento, School of Medicine of Jundiaí. Tatiana F Fanton, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Thaísa Bortoletto Guedes, Department of Tocogynecology, School of Medical Sciences, State University of Campinas. Valter Lacerda de Andrade Junior, Serasa Experian. Bill & Melinda Gates Foundation [OPP1107597], the Brazilian Ministry of Health, and the Brazilian National Council for Scientific and Technological Development (CNPq) [401615/20138]. The funders had no role in the design, development of the study, analysis, interpretation of data, writing the manuscript and in the decision to submit the article for publication. T.V.S. was supported by Coordenação de Aperfeiçoamento Pessoal de Nível Superior - CAPES (grant number 001)
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Abstract: Short 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...
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Abstract: Short 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. This 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. We 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. CL measured by transvaginal ultrasound should be used to predict sPTB<34 weeks. Women with CL=30 mm are at increased risk for late sPTB
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CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ
401615/2013-8
COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPES
001
Aberto
Association between cervical length and gestational age at birth in singleton pregnancies : a multicentric prospective cohort study in the Brazilian population
Thais Valériasilva, 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
Association between cervical length and gestational age at birth in singleton pregnancies : a multicentric prospective cohort study in the Brazilian population
Thais Valériasilva, 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
Fontes
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Reproductive health v. 20, n. art. 47, 2023 |