title: Rate of sonographic cervical shortening and biologic pathways of spontaneous preterm birth.
abstract: OBJECTIVE
  The objective of the study was to estimate the relationship between midtrimester cervical length (CL) and maternal serum markers of systemic inflammation, activation of the maternal-fetal hypothalamic-pituitary axis, and alterations in thrombosis-hemostasis.
  
  
  METHODS
  This is a secondary analysis of a prospective cohort study designed to predict preterm birth in the general obstetric population. Women had serial CL ultrasounds and assessment of maternal serum corticotrophin-releasing hormone, C-reactive protein, and thrombin-antithrombin III complexes between 20 and 33 weeks' gestation and were followed up until delivery.
  
  
  RESULTS
  Shortening of CL was associated with the rate of rise in corticotrophin-releasing hormone (r(2) = 0.34, P = .014) and C-reactive protein (r(2) = 0.44, P = .001) for women with CL less than 25 mm but not for the cohort overall. There was no association of change in CL with change in thrombin-antithrombin III concentration.
  
  
  CONCLUSIONS
  Among women with a midtrimester sonographically short cervix, changes in serum markers suggest that a shortening CL may be associated with systemic inflammation and activation of the maternal-fetal hypothalamic-pituitary axis but not systemic thrombosis-hemostasis.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Moroz
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Hyagriv N
authors.initials: HN
authors.lastname: Simhan
mesh_terms: D000293:Adolescent; D000328:Adult; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D002584:Cervix Uteri / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D003346:Corticotropin-Releasing Hormone / Q000032:analysis; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D016014:Linear Models; D007752:Obstetric Labor, Premature / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D011262:Pregnancy Trimester, Second / Q000502:physiology*; D047928:Premature Birth / Q000000981:diagnostic imaging / Q000378:metabolism*; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D000990:Antithrombin III; D002097:C-Reactive Protein; D003346:Corticotropin-Releasing Hormone
keywords: cervical length; corticotrophin-releasing hormone; inflammation; preterm birth