Gestational age at cervical length measurement and preterm birth in twins

Authors

  • R. M. Ehsanipoor,

    Corresponding author
    1. Division of Maternal–Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
    2. Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California, USA
    • Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, 600 North Wolfe Street, Phipps 228, Baltimore, MD, USA 21287

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  • M. L. Haydon,

    1. Department of Obstetrics and Gynecology, Hoag Memorial Hospital Presbyterian, Newport Beach, California, USA
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  • C. Lyons Gaffaney,

    1. Obstetrix Medical Group, San Jose, Campbell, California, USA
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  • J. A. Jolley,

    1. Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California, USA
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  • R. Petersen,

    1. Center for Statistical Consulting, University of California, Irvine, California, USA
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  • D. C. Lagrew,

    1. Department of Obstetrics and Gynecology, Saddleback Memorial Medical Center, Laguna Hills, California, USA
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  • D. A. Wing

    1. Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California, USA
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Abstract

Objectives

To estimate the risk of preterm delivery of twin pregnancies based upon sonographic cervical length measurement and gestational age at measurement.

Methods

Twin pregnancies that delivered between 1999 and 2005 and that underwent sonographic measurement of cervical length between 13 and 34 + 6 weeks' gestation were identified and a retrospective review performed. Women with anomalous pregnancies, multifetal reduction, cerclage placement or medically indicated deliveries before 35 weeks were excluded. Logistic regression analysis was used to estimate the risk of preterm delivery before 35 weeks.

Results

A total of 561 women underwent 2975 sonographic cervical length measurements during the study period. The rate of preterm delivery before 35 weeks was 19.4%. The risk of delivery before 35 weeks decreased by approximately 5% for each additional mm of cervical length (odds ratio (OR) 0.95 (95% CI, 0.93–0.97); P < 0.001) and by approximately 6% for each additional week at which the cervical length was measured (OR 0.94 (95% CI, 0.92–0.96); P < 0.001).

Conclusion

The gestational age at which cervical length is measured is an important consideration when estimating the risk of spontaneous preterm birth in twins. The risk of preterm delivery is increased at earlier gestational ages and as cervical length decreases. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

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