title: First-trimester screening for spontaneous preterm delivery with maternal characteristics and cervical length.
abstract: OBJECTIVE
  It was the aim of this study to examine the potential value of cervical length at 11-13 weeks' gestation in the prediction of spontaneous preterm delivery.
  
  
  METHODS
  This was a screening study for spontaneous preterm delivery in singleton pregnancies from cervical length measured by transvaginal ultrasound at 11-13 weeks' gestation. The performance of screening for preterm delivery by cervical length alone and with maternal characteristics was estimated.
  
  
  RESULTS
  In the 9,974 pregnancies included in the study, spontaneous delivery before 34 weeks occurred in 104 (1.0%) cases. Multivariate regression analysis in the term delivery group demonstrated that for the log(10) cervical length, significant independent contributions were provided by fetal crown-rump length, maternal height, age, racial origin and parity. The median cervical length multiple of the median (MoM), corrected for maternal characteristics, was significantly lower in the preterm (0.892 MoM, 95% CI 0.829-0.945) than in the term delivery group (0.994 MoM, 95% CI 0.919-1.082; p < 0.0001). In screening by a combination of maternal characteristics and cervical length, the estimated detection rate of preterm delivery was 54.8% (95% CI 44.7-64.6), at a false-positive rate of 10%.
  
  
  CONCLUSIONS
  Effective first-trimester screening for spontaneous early preterm delivery can be provided by a combination of maternal characteristics and cervical length.
authors.affiliation: Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.
authors.forename: Elena
authors.initials: E
authors.lastname: Greco
authors.forename: Rachna
authors.initials: R
authors.lastname: Gupta
authors.forename: Argyro
authors.initials: A
authors.lastname: Syngelaki
authors.forename: Leona C Y
authors.initials: LC
authors.lastname: Poon
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D004739:England; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D047928:Premature Birth / Q000000981:diagnostic imaging* / Q000209:etiology*; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D016216:Ultrasonography, Prenatal