Cervical length varies considering different populations and gestational outcomes: Results from a systematic review and meta-analysis

Autor: Ben W.J. Mol, Michele Franca, José Guilherme Cecatti, Thaís V Silva, Anderson Borovac-Pinheiro, Rodolfo C. Pacagnella, Renato Passini, Thaísa Guedes Bortoletto, J. P. Argenton, A. R. Hatanaka, A. D. Silva, Cynara Maria Pereira
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Epidemiology
Maternal Health
Cervix Uteri
Cervix
Diagnostic Radiology
Database and Informatics Methods
Mathematical and Statistical Techniques
Pregnancy
Risk Factors
Ultrasound Imaging
Medicine and Health Sciences
Medicine
Cutoff
Database Searching
education.field_of_study
Multidisciplinary
Obstetrics
Radiology and Imaging
Statistics
Obstetrics and Gynecology
Metaanalysis
Research Assessment
Cervical Length Measurement
medicine.anatomical_structure
Systematic review
Meta-analysis
Physical Sciences
Premature Birth
Female
Anatomy
Genital Anatomy
Research Article
medicine.medical_specialty
Asia
Systematic Reviews
Imaging Techniques
Science
Population
Gestational Age
Preterm Birth
Research and Analysis Methods
Diagnostic Medicine
Humans
Statistical Methods
Risk factor
education
business.industry
Infant
Newborn
Reproductive System
Biology and Life Sciences
medicine.disease
Pregnancy Complications
Medical Risk Factors
Africa
Birth
Women's Health
business
Mathematics
Zdroj: PLoS ONE, Vol 16, Iss 2, p e0245746 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Background The uterine cervical length is an important risk factor for preterm birth. The aim of this study was to assess cervical length distribution in women with singleton pregnancies, measured by transvaginal ultrasound between 16 and 24 weeks, and its association with population characteristics. Materials and methods We searched electronic databases and other sources for studies published from April 1, 1990 to July 21, 2020. Of the 2019 retrieved publications, full-text versions of 137 articles were considered. We included 77 original articles that reported cervical length measurements of 363,431 women. The main aim of this study was to identify the pattern of cervical length in different populations. We collected demographic and clinical data concerning the population, in addition to information regarding the ultrasound examination and cervical length measurement. Regarding study bias, 56 were at low risk of bias and 21 were at medium risk of bias. Results The meta-analysis included 57 articles with data from 158,346 women. The mean cervical length was 37.96. mm (95% CI [36.68, 39.24]). Cervical length was shorter in women from Africa and Asia, in those from low-income countries, with a lower body weight, and in those who delivered before 37 gestational weeks. We found that the cervical length from pooled studies is longer than that usually discussed in the literature. Regarding limitations, we had difficulty assessing our main variable because there was no consistent pattern in the way authors reported cervical length measurement. Another limitation was the great heterogeneity between studies. Conclusions The use of a single cutoff value to define a short cervix diagnosis, an important risk factor for preterm birth, may not be correct and cervical length must be considered according to maternal population characteristics. Future studies should identify different specific curves and cutoff values for cervical length in different populations. This meta-analysis was registered in the PROSPERO database under CRD42017070246 at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=70246.
Databáze: OpenAIRE
Externí odkaz: