Timing of mid-trimester cervical length shortening in high-risk women.
Timing of mid-trimester cervical length shortening in high-risk women.
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DOI：
10.1002/uog.6283
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发表时间：
2009-01
影响因子：
7.1
通讯作者：
Guzman, E. R.
中科院分区：
文献类型：
--
作者：
Szychowski, J. M.;Owen, J.;Hankins, G.;Iams, J.;Sheffield, J.;Perez-Delboy, A.;Berghella, V.;Wing, D. A.;Guzman, E. R.
旨在检查女性宫颈长度缩短的自然史，这些女性在妊娠 17 + 0 – 33 + 6 周时至少经历过一次自发性早产。多中心阴道超声环扎试验的随机化前数据分析。通过阴道超声检查对 1014 名高危女性在 16+0 至 22+6 周时连续测量宫颈长度。我们通过进入随机环扎试验或达到妊娠 22 + 6 周来确定宫颈长度缩短 <25 毫米或审查的时间（以妊娠周为单位）。比较了最早早产发生在妊娠中期（定义为 <24 周与 24-33 周）的女性的宫颈长度缩短的发生率和缩短时间。根据每位患者最近的出生史进行了类似的比较。通过生存分析，宫颈长度缩短的时间显着缩短（风险比 [HR] = 2.2，p<0.0001），并且对于最早自发早产 <24 周的妇女，缩短的相对风险 (RR) 显着更高（RR = 1.8，p<0.0001）。最近一次分娩 <24 周的女性的影响更大（HR = 2.8，p<0.0001；RR = 2.1，p<0.0001）。在调整多变量 Cox 比例风险模型中的混杂因素后，观察到的风险比仍然显着。与早产史较晚的女性相比，曾有过 <24 周自发性早产史的女性发生宫颈缩短的风险更高，且发生率更高且孕龄更早。
To examine the natural history of cervical length shortening in women, who had experienced at least one prior spontaneous preterm birth at 17 + 0 – 33 + 6 weeks’ gestation. Analysis of pre-randomization data from the multicenter Vaginal Ultrasound Cerclage Trial. Serial cervical length was measured by vaginal sonography in 1014 high-risk women at 16 + 0 to 22 + 6 weeks. We determined the time (in weeks’ gestation) to cervical length shortening <25 mm, or censoring, either by entering the randomized cerclage trial or attaining 22 + 6 weeks’ gestation. The incidence of cervical length shortening and the time to shortening were compared for women whose earliest prior preterm birth was in the mid-trimester, defined as <24 weeks versus at weeks 24–33. Similar comparisons were done based on each patient’s most recent birth history. Time to cervical length shortening by survival analysis was significantly shorter (Hazard Ratio [HR] = 2.2, p<0.0001) and the relative risk (RR) of shortening significantly higher (RR = 1.8, p<0.0001) for women whose earliest prior spontaneous preterm birth was <24 weeks. A larger effect was observed for women whose most recent birth was <24 weeks (HR = 2.8, p<0.0001; RR = 2.1, p<0.0001). The observed hazard ratios remained significant after adjusting for confounders in a multivariable Cox proportional hazards model. Women with a prior spontaneous preterm birth <24 weeks are at a higher risk of cervical shortening, and do so at a higher rate and at an earlier gestational age, than do women with a later preterm birth history.
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影响因子：
9.8
作者：
Althuisius, SM;Dekker, GA;van Geijn, HP
通讯作者：
van Geijn, HP
DOI：
10.1016/s0002-9378(98)70544-7
发表时间：
1998-05-01
影响因子：
9.8
作者：
Iams, JD;Goldenberg, RL;Roberts, JM
通讯作者：
Roberts, JM
影响因子：
7.2
作者：
Alexander, GR;Himes, JH;Kogan, M
通讯作者：
Kogan, M
影响因子：
9.8
作者：
McManemy, Julie;Cooke, Erinn;Leet, Terry
通讯作者：
Leet, Terry
影响因子：
120.7
作者：
Owen, J;Yost, N;McNellis, D
通讯作者：
McNellis, D