title: Gestational age at cervical length measurement and preterm birth in twins.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland 21287, USA. rehsani1@jhmi.edu
authors: R M
authors: RM
authors: Ehsanipoor
authors: M L
authors: ML
authors: Haydon
authors: C
authors: C
authors: Lyons Gaffaney
authors: J A
authors: JA
authors: Jolley
authors: R
authors: R
authors: Petersen
authors: D C
authors: DC
authors: Lagrew
authors: D A
authors: DA
authors: Wing
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D054791:Cervical Length Measurement / Q000379:methods*; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D047928:Premature Birth / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014427:Twins; D016216:Ultrasonography, Prenatal