{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:14:38Z","timestamp":1780474478341,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003970","name":"Isfahan University of Medical Sciences","doi-asserted-by":"publisher","award":["890034"],"award-info":[{"award-number":["890034"]}],"id":[{"id":"10.13039\/501100003970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To predict spontaneous preterm birth (sPTB) (labor before 37\u2009weeks of pregnancy) in low\u2010risk singleton pregnancies during the second trimester, using ultrasound markers: uterocervical angle (UCA) and cervical length (CL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective observational cohort study, we followed primigravid women with singleton pregnancies without known risk factors for sPTB from 16<jats:sup>+0\u2013<\/jats:sup>23<jats:sup>+6<\/jats:sup> weeks of pregnancy until birth. Transvaginal ultrasonography on admission revealed the UCA and CL, and maternal history was obtained from submitted patient profiles. Logistic regression models disclosed significant predictive variables, and receiver operating curves (ROCs) demonstrated optimal cut\u2010offs and test accuracy indices. Predictive functions of variables were compared using positive and negative likelihood ratios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a sample of 357 participants, 41 (11.5%) experienced sPTB. UCA and CL were significantly associated with sPTB when adjusting for other variables (adjusted odds ratio: UCA 1.05, 95% confidence interval [CI] 1.02\u20131.07 and CL 0.82, 95% CI 0.75\u20130.90). Optimal cut\u2010offs were estimated to be 106\u00b0 and 33\u2009mm for UCA and CL, respectively. We devised the novel index UCA\/CL with an area under the ROC of 0.781 (95% CI 0.734\u20130.823), cut\u2010off\u2009=\u20093.09\u00b0\/mm, and improved likelihood ratios (positive: 3.18, 2.47, and 4.22; negative: 0.63, 0.52, and 0.51 for UCA, CL, and UCA\/CL, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The second\u2010trimester UCA\/CL was found to be a promising index to predict sPTB in low\u2010risk singleton pregnancies. Further multicenter studies may generalize this conclusion to other gestational ages or risk groups and make it more comprehensive by considering other risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15361","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T13:18:51Z","timestamp":1705497531000},"page":"1122-1129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The uterocervical angle\u2010cervical length ratio: A promising predictor of preterm birth?"],"prefix":"10.1002","volume":"165","author":[{"given":"Minoo","family":"Movahedi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Goharian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8462-1466","authenticated-orcid":false,"given":"Sina","family":"Rasti","sequence":"additional","affiliation":[{"name":"Department of Radiology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaheh","family":"Zarean","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7875-4572","authenticated-orcid":false,"given":"Mohammad Javad","family":"Tarrahi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Shahshahan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Preterm birth: WHO.2022. 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