Does Cervical Length Actually Predict Preterm Birth?
This study by Esplin et al. (JAMA, 2017) analyzed cervical length and serial measurements of vaginal fetal fibronectin levels to determine whether they are good predictors for spontaneous preterm birth.
Multi-center Prospective Observational Cohort Study
9,410 nulliparous women of varied racial and ethnic backgrounds were included in the study. 5% of these women had spontaneous preterm deliveries. Only 8% of the women who experienced spontaneous preterm birth had a cervical length of ≤ 25mm at 15-22 weeks gestation while 23.3% had a shortened cervical length at 22-30 weeks gestation. Among women with spontaneous preterm birth, fetal fibronectin levels of ≥ 50 ng/mL were seen in 7.3% of women at 16-22 weeks gestation and 8.1% in women at 22-30 weeks gestation. Based on the above, the authors concluded that neither cervical length nor quantitative fetal fibronectin levels are useful in predicting spontaneous preterm birth in the setting of nulliparous women with singleton pregnancies.
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