孕期宫颈长度变化与早产预测

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-09-23 DOI:10.1007/s00404-024-07745-2
A. P. Souka, V. Maritsa, P. Antsaklis, A. Pilalis, G. Daskalakis
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引用次数: 0

摘要

目的:根据纵向测量结果构建孕期宫颈长度(CL)参考图表,并评估妊娠 24 周后测量宫颈长度的价值:经阴道测量单胎妊娠 5 至 41 周时的宫颈长度。测量超过一次的孕妇被用于创建宫颈长度图表,而 24 周后的任何测量值都被用于评估宫颈长度与早产的相关性:数据集包括 12,601 例妊娠和 33,899 个观测值。妊娠年龄是预测CL的主要因素(R2 = 67.3%)。在固定效应部分对产妇特征(年龄、体重指数、吸烟状况、胎次、流产史和宫颈手术)做进一步调整,提高了预测能力(R2 = 78.4%)。如果在 24 至 35 周之间的任何孕期测量,CL 可预测 37 周前的自然早产;如果在 28 至 31 周之间测量,CL 可预测 32 周前的自然早产(AUC = 0.68):胎龄是预测CL的主要因素,其次是母体特征和病史。结论:胎龄是预测CL的主要因素,其次是孕产妇特征和病史。在24周到35+6周之间进行CL评估可提高我们预测自发性早产的能力。
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Cervical length evolution in pregnancy and prediction of preterm delivery

Purpose

To construct reference charts for cervical length (CL) in pregnancy based on longitudinal measurements and to assess the value of measuring cervical length after 24 weeks of gestation.

Methods

CL was measured transvaginally in singleton pregnancies at 5 to 41 weeks. Pregnancies with more than one measurement were used for creating the CL chart, whereas any measurement after 24 weeks was considered for assessing the correlation of CL with preterm delivery.

Results

The dataset consisted of 12,601 pregnancies and 33,899 observations. Gestational age was the main predictor of CL (R2 = 67.3%). Further adjustments in the fixed effects part for maternal characteristics (age, BMI, smoking status, parity, history of miscarriage, and cervical surgery) improved the prediction ability (R2 = 78.4%). CL was predictive of spontaneous preterm delivery before 37 weeks when measured at any gestation between 24 and 35 weeks and it was predictive of spontaneous preterm delivery before 32 weeks when measured between 28 and 31 weeks (AUC = 0.68).

Conclusion

Gestational age is the main predictor of CL followed by maternal characteristics and history. CL assessment between 24 and 35 + 6 weeks can enhance our ability to predict spontaneous preterm delivery.

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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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