Produção Nacional
Revisado por pares
Association between cervical length and gestational age at birth in singleton pregnancies: a multicentric prospective cohort study in the Brazilian population
2023; BioMed Central; Volume: 20; Issue: 1 Linguagem: Inglês
10.1186/s12978-022-01557-w
ISSN1742-4755
AutoresThaís Silva, Anderson Borovac‐Pinheiro, José Guilherme Cecatti, Ben W. Mol, Fabrício da Silva Costa, Marcelo Santucci França, Renato T. Souza, Roland Devlieger, Renato Passini, Rodolfo C. Pacagnella, Allan R Hatanaka, Amanda Lúcia Barreto Dantas, Antônio Fernandes Moron, Carlos Augusto Santos Menezes, Cláudio Sérgio Medeiros Paiva, Cristhiane B Marques, Cynara Maria Pereira, Daniela dos Santos Lopes Homenko, Djacyr Magna Cabral Paiva, Elaine Christine Dantas Moisés, Enoch Quinderé Sá Barreto, Felipe Soares, Fernando Maia Peixoto Filho, Francisco Edson de Lucena Feitosa, Francisco Herlânio Costa Carvalho, Jessica Scremin Boechem, João Renato Benini-Junior, José Airton Oliveira Lima, Juliana P. Argenton, Kaline F Marquart, Karayna Gil Fernandes, Kléber Cursino de Andrade, Leila Katz, Maíra Rossmann Machado, Marcelo Luís Nomura, Marcelo Marques Souza Lima, Marcos Nakamura‐Pereira, Maria J. Miele, Maria Laura Costa, Mário Dias Corrêa Júnior, Nathalia Ellovitch, Nelson Sass, Rodrigo Paupério Soares de Camargo, Sabrina Savazoni, Samira El Maerrawi Tebecherane Haddad, Sérgio Hofmeister de Almeida Martins Costa, Silvana Ferreira Bento, Silvana Maria Quintana, Stéphanno Gomes Pereira Sarmento, Tatiana F. Fanton, Thaísa Bortoletto Guedes, Valter Lacerda de Andrade,
Tópico(s)Ectopic Pregnancy Diagnosis and Management
ResumoAbstract Background 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. Methods 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. Results 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. Conclusions 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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